[HN Gopher] Data breach at Kaiser Permanente affects 13.4M people
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       Data breach at Kaiser Permanente affects 13.4M people
        
       Author : kryster
       Score  : 96 points
       Date   : 2024-04-26 17:15 UTC (5 hours ago)
        
 (HTM) web link (restoreprivacy.com)
 (TXT) w3m dump (restoreprivacy.com)
        
       | waihtis wrote:
       | Genuinely think cyber has a massive overengineering problem - I
       | havent worked with Kaiser but am under the impression they run
       | quite a sophisticated op, with a lot of advanced modeling done
       | for vulns & cyber risk in general. Yet they got pounded pretty
       | hard here.
       | 
       | Creeping suspicion is too much focus on doing "smart" things with
       | data, AI and such and not enough on actually worrying about not
       | getting breached.
        
         | thephyber wrote:
         | > Yet they got pounded here
         | 
         | Huh? Your passive tense suggests this happened _to_ KP's teams.
         | 
         | From what I'm reading, those are the teams who would have had
         | to actively take action to import the tracking code on their
         | pages.
         | 
         | My money is on "we imported a thing on the website because our
         | advertising team needed to know when advertised users converted
         | from any of many different advertising channels". Usually it's
         | easier to import a script on a common layout, rather than just
         | a single landing page.
         | 
         | Ad teams overrule the website / security teams because one is a
         | profit center and the other is a cost center.
         | 
         | Then as engineers / product teams turn over, the new employees
         | don't know the original intention of the old imported code and
         | are wary to remove it (and if they do, the process is long and
         | drawn out).
        
       | GraffitiTim wrote:
       | This is why we need Freshpaint (YC S19) for analytics and other
       | services for healthcare companies. A primary focus on regulatory
       | compliance, privacy, security.
        
       | agnokapathetic wrote:
       | this is just from Share Embeds.
       | 
       | they now disclose these are used at login.
        
         | roywiggins wrote:
         | [deleted]
        
       | throwaway81523 wrote:
       | Kaiser has had another privacy bug for many years, which is they
       | give out phone numbers of individual doctors in the Kaiser system
       | (of course it goes to voice mail). That sounds great but it's
       | invasive: call a Kaiser oncologist, and your phone carrier sells
       | the number you dialed to data brokers who profile you as a likely
       | cancer patient. Call an AIDS specialist, gender transition
       | therapist, abortion provider, etc.: same idea. Kaiser should
       | instead have a single incoming phone number where you enter an
       | extension of the doctor you are trying to reach. So everyone
       | dials the same outgoing number. I griped to them about this
       | around 10 years ago and they basically said hrmmph.
        
         | lotsofpulp wrote:
         | That's a crazy solution to a legislative problem.
         | 
         | Also, source that call records are sold? I thought even the
         | government (non federal security apparatus) needed a warrant to
         | get access to that information?
        
           | 01HNNWZ0MV43FF wrote:
           | sounds like I need to start dialing some random businesses to
           | fuck up my ads
        
           | kevingadd wrote:
           | https://www.popularmechanics.com/technology/security/a23567/.
           | ..
        
             | lotsofpulp wrote:
             | The source material on page 9 and 10 claims a subpoena is
             | necessary:
             | 
             | https://archive.nytimes.com/www.nytimes.com/interactive/201
             | 3...
             | 
             | Therefore, I am confused whether or not a warrant is
             | needed. If the phone networks were straight up selling call
             | records, then surely no law enforcement agency would bother
             | with warrants.
        
               | whaleofatw2022 wrote:
               | Buying the records could cause issues potentially in
               | court. The selling of 'evidence' can cause various
               | conflicts of interest.
               | 
               | That said I would be completely unsurprised if they were
               | used for 'parallel discovery' purposes.
        
               | throwaway81523 wrote:
               | Call records have never needed a warrant (lookup "pen
               | registers"). Call contents (i.e. wiretaps) have in
               | principle always needed a warrant, modulo many
               | exceptions. These days though, call records seem to be
               | for sale to anyone who wants them, whether or not that is
               | legal.
        
               | gopher_space wrote:
               | A private investigator could fill us in, but if you look
               | at the different personal data services you'll see a lot
               | of "check this box to agree that you have a valid legal
               | reason to pay us $75 for your ex's info" type setups.
               | Pirate Code law.
        
               | singleshot_ wrote:
               | Subscriber data: court order.
               | 
               | Communications: warrant.
               | 
               | Metadata: it depends.
               | 
               | (Not a general rule but a useful heuristic).
        
           | hi-v-rocknroll wrote:
           | KP's phone carrier, the caller's carrier, or an intermediate
           | phone network maybe selling metadata to data brokers. The
           | current practice in America is that once data* about a person
           | has been disclosed to a business by any means, the person
           | loses all rights to it and it becomes the property of that
           | business to do with and resell it however they want.
           | 
           | * There are limited carve-outs for medical records and such.
        
             | kbenson wrote:
             | > The current practice in America is that once data* about
             | a person has been disclosed to a business by any means, the
             | person loses all rights to it and it becomes the property
             | of that business to do with and resell it however they
             | want.
             | 
             | Yes. I think what's being alluded to is that the ultimate
             | problem lies there, and carving out special systems and
             | cases to legislate to avoid bad behavior that might results
             | from that will always fall short of what we could get with
             | some more overarching legislation that makes it so the end
             | person retains at least enough rights about that data to
             | know when it's happening and preferably be able to stop it
             | and requiring very stringent rules about those that do
             | attempt it with permission from end users.
             | 
             | At that point it's no longer about finding which if the
             | data aggregators are doing unsavory things with the data
             | they get from you and trying to find some way to get them
             | to stop and it's then about any data broker that wants your
             | information trying to get you to allow it (because there
             | are undoubtedly cases where the data is good for society
             | and even good for you) needs to justify what and why and
             | how they use it.
             | 
             | Edit: And there would be legal recourse if they don't
             | follow those legal standards, of course. It's implied, but
             | might as well be stated outright.
        
               | smolder wrote:
               | I think the better starting point would be that
               | businesses have no right to share personally identifying
               | information about their customers (short of court orders)
               | and the carve outs go the other way. I should then grant
               | the "identity handling rights", by way of a license, to
               | businesses, as needed. Put some standards around the
               | language and method of establishing consent so it can't
               | be buried in EULAs, and then I'll be happy to check a box
               | to grant businesses to transact with my PII on my behalf
               | if there is a legitimate need.
        
               | hi-v-rocknroll wrote:
               | Yes, this would need grassroots single issue advancement
               | of something like a HIPAA law for general privacy and
               | personal data that starts with an opt-in standard
               | practice. There's really no way to change the structure
               | of how the current situation of data brokering works in
               | America without a broad and draconian law.
               | 
               | Perhaps there should also be a nonprofit clearinghouse
               | like a "credit agency" that provides a centralized portal
               | for reviewing all of the permission links at and between
               | businesses, and also a central point for changing phone
               | numbers, email, shipping, mailing address, etc.
        
               | kbenson wrote:
               | I think that's essentially just what I described, with
               | the main difference being that I think we'll only
               | actually get there if we approach it from the angle of
               | PII being something intrinsically owned by the
               | individual, not the company that generated it, which I
               | think is easiest approached by making it a right of some
               | sort.
               | 
               | Then the carved out allowances for specific companies or
               | industries are clear and their need can always be weighed
               | against our _rights_ , making them much easier to pull
               | back, because it's obvious when it comes to our rights
               | and the needs of an industry to continue making money,
               | our rights come first. If it's approached from a non-
               | rights angle at some point we are attempting to curtail
               | an industry, I think that might be a much more
               | contentious discussion.
               | 
               | If we can't get rights, I wouldn't mind HIPAA being
               | expanded into an overall PII protection system with two
               | or more levels, one being current HIPAA health info, and
               | the other main one being all other PII info and that
               | allows a company to collect it for internal use without
               | lots of constraints (depending on info, and purely so it
               | doesn't accidentally tank existing industries that aren't
               | problematic because all of a sudden they can't store some
               | benign info they need that the law accidentally targets)
               | but once they want to share it at all they need to adopt
               | a much more stringent framework like medical info
               | requires for tracking and accounting of it, which would
               | probably weed out the vast majority of random "collect
               | the PII and sell it because it's cheap" stuff that goes
               | on, since it's no longer low cost at all given the
               | requirements that would exist around it (including
               | authorization to share). Just the cost structure around
               | strict legal and storage compliance and requiring
               | authorization and tracking of all sharing of information
               | would disincentivize a huge amount of the abuse we see.
        
         | hi-v-rocknroll wrote:
         | Correlation between web, social media, brick and mortar
         | retailers, banking, credit, and cell phone carriers has reached
         | a level of ridiculous perversion. America needs a modern
         | German-like privacy framework. Data brokers should be illegal
         | and individuals should have final say over how uniquely
         | identifying information about them is exchanged.
        
           | smolder wrote:
           | Yes. The data hoarding creates endless opportunity for abuse
           | and only marginally improves the utility of things like
           | advertising.
           | 
           | The case of insurance providers having a microscope into
           | everyone's lives is simply dystopian. As with political
           | campaigns, potential employers, law enforcement, and so on.
        
         | bee_rider wrote:
         | Your cellphone could also report your location when you walk to
         | these medical providers, right?
        
           | KeepFlying wrote:
           | Yeah but you could theoretically turn off Location services
           | and then the cell network may not be able to tell if you're
           | at the doctors or at the McDonalds next door so it still
           | offers some (limited) privacy.
        
             | bhhaskin wrote:
             | By that logic you could in theory use a VOIP number to
             | call...
        
         | nix0n wrote:
         | So if I call some Sports Medicine doctors, then advertisers
         | will think I'm a cool, active person.
        
         | neilv wrote:
         | The solution is FBI raids on the headquarters of the carriers,
         | data brokers, and companies that buy/use/resell/share/etc. the
         | data.
         | 
         | Plus the individuals found responsible thrown into prison, and
         | personally bankrupted.
         | 
         | Plus a punitive hit to the stockholders, including clawbacks of
         | past realized gains, to align incentives better with productive
         | society, and not let a corporation be a shield for routine
         | criminal conspiracy.
         | 
         | Working backwards from the desired state, what legislation do
         | we need?
        
           | drstewart wrote:
           | >Working backwards from the desired state, what legislation
           | do we need?
           | 
           | Not much for the jackboot police state you look to create
        
         | SAI_Peregrinus wrote:
         | This is not unique to Kaiser. Anyone not on an HMO plan has
         | separate providers for separate specialties.
        
         | Dalewyn wrote:
         | >I griped to them about this around 10 years ago and they
         | basically said hrmmph.
         | 
         | To be fair to Kaiser, that really isn't their problem.
         | 
         | You should be griping to the telco (yes, I know it's a waste of
         | time) and your politicians (marginally more useful than the
         | former), because that is their problem.
        
       | ComputerGuru wrote:
       | Do you think they still have my records from 30 years ago? Not
       | really kidding, actually curious if that data was ever properly
       | migrated from system to system.
        
         | kevingadd wrote:
         | My historical records were never digitized by KP, they're on
         | paper in a storage bin somewhere.
        
           | ComputerGuru wrote:
           | Curious how you know and how far back you are referring to?
           | Did you stick with them throughout -- if so, I would imagine
           | they would have had extra incentive to import just yours, at
           | the very least (and others like you, obviously).
           | 
           | Glad to know they're a forest fire away from being lost. If
           | you haven't used your medical records or had them forwarded
           | to another provider in over three decades, I think it's ok if
           | they go bye-bye.
        
           | el_benhameen wrote:
           | My visit information wasn't digitized as far as I know, but
           | my vaccine records and possibly other records from the 1980s
           | are in my kp account.
        
             | patja wrote:
             | About 10 years ago they dug up all my Group Health Coop
             | (since bought by Kaiser) vaccine records since 1970 and
             | updated the digital record to include them
        
       | phone8675309 wrote:
       | It should be illegal for any private company to hold that much
       | personal information
        
         | hi-v-rocknroll wrote:
         | Every American voter could call and/or write physical letters
         | to their representatives to express their displeasure about the
         | lack of purchase, web, and financial data and telco metadata
         | privacy rights.
         | 
         | https://www.commoncause.org/find-your-representative/
        
       | hi-v-rocknroll wrote:
       | Ouch. Perhaps they still have records of doctor incompetence when
       | they nearly killed me at birth at their demolished Santa Clara
       | location. KP is a good deal when or if you are healthy but not so
       | great if you aren't.
        
       | nikolay wrote:
       | It's always the SOC 2 and HIPAA-compliant companies that get
       | breached, but, of course, mostly compliant companies are
       | lucrative targets.
        
         | bearjaws wrote:
         | It's because HIPAA is a joke and SOC2 is basically the bare
         | minimum at this point.
         | 
         | Too many little ways to manipulate your artifacts to pass SOC2
         | and no accountability when it goes wrong.
        
           | gopher_space wrote:
           | Sat in a hospital room with a relative for two weeks and saw
           | staff repeatedly violate compliance directives in order to
           | provide timely care. They clearly weren't being provided the
           | resources needed to do so.
           | 
           | Also, for the entrepreneurs out there, they seem to really
           | need some kind of tubing that won't collect air bubbles.
           | Something with a hydrophobic interior? I don't know. There's
           | a related area regarding flushing IV systems that could use
           | attention as well.
        
       | xyst wrote:
       | Anyone that has worked in a sector where technology is often a
       | second tier citizen or after thought knows these types of
       | breaches are inevitable.
       | 
       | Hospitals. Banks. Airline industry.
       | 
       | The shit I have seen in just these industries made me think twice
       | about having my private information held here.
       | 
       | Of course, the "IT" is often outsourced or "in sourced" (often
       | juniors fresh out of college). Thus simple shit such as network
       | segmenting production and development environments; and limiting
       | access to production databases/assets is nonexistent.
       | 
       | I remember working in an airline where the backend systems were
       | still running on outdated mainframe systems. Nobody had a clue
       | how the existing mainframe systems worked. No documentation. Only
       | poorly maintained support docs on how to keep it running. I ended
       | up silent quitting after 3 months because management kept
       | shutting down all of my initiatives to improve ops and quality.
       | This company later had a massive meltdown. I wasn't surprised and
       | just glad I wasn't subpoenaed.
        
       | cnj wrote:
       | > The data exposure was discovered following an internal
       | investigation conducted voluntarily by Kaiser Permanente. The
       | company discovered that online trackers used on its websites and
       | mobile applications were transmitting certain types of personal
       | data when users interacted with its services.
       | 
       | I have respect for the individuals that started this
       | investigation, and the ones that made sure this is publicly
       | disclosed. This could have easily been swept under the carpet.
       | 
       | Actually, that they uncovered this on their own and publicly
       | disclosed it sounds like they have an above-average privacy
       | culture in place.
       | 
       | I know the odds that the person(s) who kicked off this
       | investigation are reading this comment are very low, but if so:
       | Kudos, well done!
        
       | shreezus wrote:
       | None of this surprises me one bit. I have worked in the health
       | space for several years, and I have personally seen the inner
       | workings of several insurers and the manmade horrors within.
       | 
       | It blows my mind that these multibillion dollar institutions are
       | so poorly managed on the technology/IT front. I think _most
       | people_ will have their health data likely leaked at some point.
        
         | peteradio wrote:
         | > I think most people will have their health data likely leaked
         | at some point.
         | 
         | Just don't go to the hospital or in any other way involve your
         | system with the InsuroServo complex. Problem solved!
        
       | mleonhard wrote:
       | I reported this to Kaiser on 2021-11-22, in support case number
       | 53710772. Below is the content of the ticket I filed. I didn't
       | follow-through on disclosure. Now I wish I had, since they could
       | have fixed this problem faster instead of taking 2.5 years.
       | 
       | I am still a satisfied Kaiser customer.
       | 
       | ----
       | 
       | Hi KP.org Team,
       | 
       | Just now, I logged into KP.org. Something was loading slowly, so
       | I viewed the network requests the website was making. I was
       | surprised to see requests to Google, Adobe, Bing, Qualtrics,
       | BTTag.com, and Unpkg.com. A request to Google includes info
       | intended to de-anonymize my computer: time, IP addr, device type,
       | display size, browser window size, timezone, and others. These
       | requests occur even while reading messages with my doctor!
       | 
       | The page loads JavaScript from Adobe, Bing, Google, and
       | Qualtrics. People who control those companies' servers can read
       | my confidential messages. Adobe has a track record of
       | incompetence in IT security.
       | 
       | Please review your decision to make KP.org load external code and
       | trackers. If you do not respond by 2022-01-14 (90 days), I will
       | disclose this information to privacy-oriented media organizations
       | and HHS.gov. I saved screenshots for this purpose.
       | 
       | Sincerely, Michael
        
         | ewhanley wrote:
         | That's pretty gross. Why would a hospital/healthcare system
         | even need all that tracking? They don't make enough from their
         | primary business that they also need to sell patient data for
         | advertising? I would guess some dev just slapped on a bunch of
         | boilerplate that so many other projects use and called it a
         | day.
        
         | adolph wrote:
         | Login page still loads up Adobe and Qualtrics. Maybe KP has BAA
         | with those services?
         | 
         | URL (gets redirected):
         | https://healthy.kaiserpermanente.org/consumer-sign-on
         | 
         | If one had a list of patient portals[0], what would be the
         | simplest way to check each for 3rd party trackers? Use
         | Selenium?                 0. curl -s
         | "https://www.mychart.org/LoginSignup" | grep 'JSON.par' | sed
         | -e 's;^.*JSON.parse('\'';;' -e 's;'\'').*$;;' | jq
         | '.Customers[].LoginUrl' | tr -d '"'
        
       | jmholla wrote:
       | Is this a HIPPA violation?
        
       | wahoo324 wrote:
       | I wonder if they had CSP and intentionally bypassed or they
       | didn't have CSP at all.
        
       | nextworddev wrote:
       | So much for hipaa
        
       | slater wrote:
       | There's something seriously wrong with the KP web department.
       | Their current site is a slow, buggy mess that regularly locks up
       | for no discernible reason on my system (M2 Air, latest Firefox
       | and macOS). Just the other day I had to nuke all the cookies to
       | log in again, because the site got itself in a login loop ("the
       | website isn't redirecting properly").
        
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