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May 12, 2024

Black Basta Ransomware: A Persistent Threat to US Healthcare

Overview of Black Basta Ransomware

Black Basta ransomware has quickly emerged as a formidable threat since it was first detected in April 2022. This group, which operates as ransomware-as-a-service (RaaS), targets a wide range of sectors, including critical infrastructures such as healthcare. The ransomware employs double-extortion tactics, which involve stealing sensitive data before encrypting the victim's files and then threatening to publish the data unless a ransom is paid. It burst on the scene in 2022 with dozens of breaches and soon thereafter, over 40% of breaches were in the U.S. and almost 16% in Australia according to Trend Micro.

Unfortunately, it took two years for America's cyberdefence agency, CISA, in partnership with the FBI, the Department of Health and Human Services (HHS), and the Multi-State Information Sharing and Analysis Center (MS-ISAC) to release a joint Cybersecurity Advisory (CSA) #StopRansomware: Black Basta to provide cybersecurity defenders tactics, techniques, and procedures (TTPs) and indicators of compromise (IOCs) used by known Black Basta ransomware affiliates and identified through FBI investigations and third-party reporting.

Recent Attacks and Tactics

The Black Basta group has been attributed to several high-profile attacks on US healthcare providers. One notable incident involved Ascension, a major healthcare provider, which experienced significant disruptions affecting electronic health records and critical communication systems. These attacks underscore the vulnerability of healthcare institutions to sophisticated cyber threats.

Black Basta's technique includes using spear-phishing to gain initial access, followed by deploying malware through methods like exploiting vulnerabilities in software and employing tools such as Qakbot and Cobalt Strike to spread laterally across the network – see more from Sentinelone and Blackberry. The group has shown a preference for targeting organizations in English-speaking countries, emphasizing the need for heightened cybersecurity measures in these regions. Trend Micro has a sold tutorial on how it does its nasty work.

Financial and Operational Impact

The financial implications of Black Basta's operations are substantial, with the group amassing over $100 million in ransom payments from its various attacks. The cost to affected organizations extends beyond the ransom payments, encompassing operational disruptions, data breach consequences, and reputational damage.

Mitigation and Prevention

Healthcare providers are urged to enhance their cybersecurity frameworks to combat ransomware threats like Black Basta. This includes regular updates to software, comprehensive employee training on phishing and other common attack vectors, and robust incident response plans. Recent developments such as the release of a decryptor for certain files affected by Black Basta prior to late 2023 offer some relief, although continuous vigilance is required as threat actors frequently update their attack methods.


The persistence and evolution of ransomware groups like Black Basta highlight the ongoing cyber risk landscape facing the healthcare sector. It is critical for healthcare providers to prioritize and strengthen their cybersecurity measures to protect patient data and maintain operational integrity. As ransomware tactics continue to evolve, so too must the defensive strategies employed by at-risk organizations.

If you are looking for an honest assessment of your cybersecurity posture – trust the cybersecurity and business continuity experts at Apex Technology Services.


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