An Overview of the New Rhysida Ransomware Targeting the Healthcare Sector

By: Trend Micro Research
August 09, 2023
Read time: 7 min (1966 words)

Updated on August 9, 2023, 9:30 a.m. EDT: We updated the entry to include an analysis of current Rhysida ransomware samples’ encryption routine.  
Updated on August 14, 2023, 6:00 a.m. EDT: We updated the entry to include Trend XDR workbench alerts for Rhysida and its components.

Introduction

On August 4, 2023, the HHS’ Health Sector Cybersecurity Coordination Center (HC3) released a security alert about a relatively new ransomware called Rhysida (detected as Ransom.PS1.RHYSIDA.SM), which has been active since May 2023. In this blog entry, we will provide details on Rhysida, including its targets and what we know about its infection chain.

Who is behind the Rhysida ransomware?

Not much is currently known about the threat actors behind Rhysida in terms of origin or affiliations. According to the HC3 alert, Rhysida poses itself as a “cybersecurity team” that offers to assist victims in finding security weaknesses within their networks and system. In fact, the group’s first appearance involved the use of a victim chat support portal.

Who are Rhysida’s targets?

As mentioned earlier, Rhysida, which was previously known for targeting the education, government, manufacturing, and tech industries, among others — has begun conducting attacks on healthcare and public health organizations. The healthcare industry has seen an increasing number of ransomware attacks over the past five years.  This includes a recent incident involving Prospect Medical Holdings, a California-based healthcare system, that occurred in early August (although the group behind the attack has yet to be named as of writing).

Data from Trend Micro™ Smart Protection Network™ (SPN) shows a similar trend, where detections from May to August 2023 show that its operators are targeting multiple industries rather than focusing on just a single sector.

The threat actor also targets organizations around the world, with SPN data showing several countries where Rhysida binaries were detected, including Indonesia, Germany, and the United States.

Figure 1. The industry and country detection count for Rhysida ransomware based on Trend SPN data from May to August 2023
Figure 1. The industry and country detection count for Rhysida ransomware based on Trend SPN data from May to August 2023
Figure 1. The industry and country detection count for Rhysida ransomware based on Trend SPN data from May to August 2023

How does a Rhysida attack proceed?

Figure 2. The Rhysida ransomware infection chain
Figure 2. The Rhysida ransomware infection chain

Rhysida ransomware usually arrives on a victim’s machine via phishing lures, after which Cobalt Strike is used for lateral movement within the system.

Additionally, our telemetry shows that the threat actors execute PsExec to deploy PowerShell scripts and the Rhysida ransomware payload itself. The PowerShell script (g.ps1), detected as Trojan.PS1.SILENTKILL.A, is used by the threat actors to terminate antivirus-related processes and services, delete shadow copies, modify remote desktop protocol (RDP) configurations, and change the active directory (AD) password.

Interestingly, it appears that the script (g.ps1) was updated by the threat actors during execution, eventually leading us to a PowerShell version of the Rhysida ransomware.

Rhysida ransomware employs a 4096-bit RSA key and AES-CTR for file encryption, which we discuss in detail in a succeeding section. After successful encryption, it appends the .rhysida extension and drops the ransom note CriticalBreachDetected.pdf.

This ransom note is fairly unusual — instead of an outright ransom demand as seen in most ransom notes from other ransomware families, the Rhysida ransom note is presented as an alert from the Rhysida “cybersecurity team” notifying victims that their system has been compromised and their files encrypted. The ransom demand comes in the form of a “unique key” designed to restore encrypted files, which must be paid for by the victim.

Summary of malware and tools used by Rhysida

  • Malware: RHYSIDA, SILENTKILL, Cobalt Strike
  • Tools: PsExec
Initial AccessPhishingBased on external reports, Rhysida uses phishing lures for initial access
Lateral MovementPsExecMicrosoft tool used for remote execution
Cobalt Strike3rd party tool abused for lateral movement
Defense EvasionSILENTKILLMalware deployed to terminate security-related processes and services, delete shadow copies, modify RDP configurations, and change the AD password
ImpactRhysida ransomwareRansomware encryption
Table 1. A summary of the malware, tools, and exploits used by Rhysida

A closer look at Rhysida’s encryption routine 
After analyzing current Rhysida samples, we observed that the ransomware uses LibTomCrypt, an open-source cryptographic library, to implement its encryption routine. Figure 3 shows the procedures Rhysida follows when initializing its encryption parameters. 

Figure 3. Rhysida’s parameters for encryption
Figure 3. Rhysida’s parameters for encryption

Rhysida uses LibTomCrypt’s pseudorandom number generator (PRNG) functionalities for key and initialization vector (IV) generation. The init_prng function is used to initialize PRNG functionalities as shown in Figure 4. The same screenshot also shows how the ransomware uses the library’s ChaCha20 PRNG functionality.

rhysida_fig4
Figure 4. Rhysida’s use of the “init_prng” function

After the PRNG is initialized, Rhysida then proceeds to import the embedded RSA key and declares the encryption algorithm it will use for file encryption:

  •  
  • It will use the register_cipher function to “register” the algorithm (in this case, aes), to its table of usable ciphers.
  •  
  • It will use the find_cipher function to store the algorithm to be used (still aes), in the variable CIPHER.

Afterward, it will proceed to also register and declare aes for its Cipher Hash Construction (CHC) functionalities. 

Based on our analysis, Rhysida’s encryption routine follows these steps:

  1. After it reads file contents for encryption, it will use the initialized PRNG’s function, chacha20_prng_read, to generate both a key and an IV that are unique for each file.
  2. It will use the ctr_start function to initialize the cipher that will be used, which is aes (from the variable CIPHER), in counter or CTR mode.
  3. The generated key and IV are then encrypted with the rsa_encrypt_key_ex function.
  4. Once the key and IV are encrypted, Rhysida will proceed to encrypt the file using LibTomCrypt’s ctr_encrypt function.
Figure 5. Rhysida’s encryption routine
Figure 5. Rhysida’s encryption routine

Unfortunately, since each encrypted file has a unique key and IV — and only the attackers have a copy of the associated private key — decryption is currently not feasible.

How can organizations protect themselves from Rhysida and other ransomware families?

Although we are still in the process of fully analyzing Rhysida ransomware and its tools, tactics, and procedures (TTPs), the best practices for defending against ransomware attacks still holds true for Rhysida and other ransomware families.

Here are several recommended measures that organizations implement to safeguard their systems from ransomware attacks:

  • Create an inventory of assets and data
  • Review event and incident logs
  • Manage hardware and software configurations.
  • Grant administrative privileges and access only when relevant to an employee’s role and responsibilities.
  • Enforce security configurations on network infrastructure devices like firewalls and routers.
  • Establish a software whitelist permitting only legitimate applications
  • Perform routine vulnerability assessments
  • Apply patches or virtual patches for operating systems and applications
  • Keep software and applications up to date using their latest versions
  • Integrate data protection, backup, and recovery protocols
  • Enable multifactor authentication (MFA) mechanisms
  • Utilize sandbox analysis to intercept malicious emails
  • Regularly educate and evaluate employees’ security aptitude
  • Deploy security tools (such as XDR) which are capable of detecting abuse of legitimate applications

Indicators of compromise

Hashes

The indicators of compromise for this entry can be found here.

MITRE ATT&CK Matrix

Initial AccessT1566 PhishingBased on external reports, Rhysida uses phishing lures for initial access.
ExecutionT1059.003 Command and Scripting Interpreter: Windows Command ShellIt uses cmd.exe to execute commands for execution.
T1059.001 Command and Scripting Interpreter: PowerShellIt uses PowerShell to create scheduled task named Rhsd pointing to the ransomware.
PersistenceT1053.005 Scheduled Task/Job: Scheduled TaskWhen executed with the argument -S, it will create a scheduled task named Rhsd that will execute the ransomware
Defense EvasionT1070.004 Indicator Removal: File DeletionRhysida ransomware deletes itself after execution. The scheduled task (Rhsd) created would also be deleted after execution.
T1070.001 Indicator Removal: Clear Windows Event LogsIt uses wevtutil.exe to clear Windows event logs.
DiscoveryT1083 File and Directory DiscoveryIt enumerates and looks for files to encrypt in all local drives.
T1082 System Information DiscoveryObtains the following information:Number of processorsSystem information
ImpactT1490 Inhibit System RecoveryIt executes uses vssadmin to remove volume shadow copies
T1486 Data Encrypted for ImpactIt uses a 4096-bit RSA key and Cha-cha20 for file encryption.It avoids encrypting files with the following strings in their file name:.bat.bin.cab.cmd.com.cur.diagcab.diagcfg.diagpkg.drv.dll.exe.hlp.hta.ico.msi.ocx.ps1.psm1.scr.sys.ini.Thumbs.db.url.isoIt avoids encrypting files found in the following folders:$Recycle.BinBootDocuments and SettingsPerfLogsProgramDataRecoverySystem Volume InformationWindows$RECYCLE.BINApzDataIt appends the following extension to the file name of the encrypted files:.rhysidaIt encrypts all system drives from A to Z.It drops the following ransom note:{Encrypted Directory}\CriticalBreachDetected.pdf
T1491.001 Defacement: Internal DefacementIt changes the desktop wallpaper after encryption and prevents the user from changing it back by modifying the NoChangingWallpaper registry value.

Trend Micro Solutions

Trend solutions such as Apex One Deep Security,  Cloud One Workload SecurityWorry-Free Business Security,  Deep Discovery Web InspectorTitanium Internet Security, and Cloud Edge can help protect against attacks employed by the Rhysida ransomware.

The following solutions protect Trend customers from Rhysida attacks:

Trend Micro solutionsDetection Patterns / Policies / Rules
Trend Micro Apex OneTrend Micro Deep SecurityTrend Micro Titanium Internet SecurityTrend Micro Cloud One Workload Security Trend Micro Worry-Free Business Security ServicesRansom.Win64.RHYSIDA.SMRansom.Win64.RHYSIDA.THEBBBCRansom.Win64.RHYSIDA.THFOHBCTrojan.PS1.SILENTKILL.SMAJCTrojan.PS1.SILENTKILL.A
Trend Micro Apex OneTrend Micro Deep SecurityTrend Micro Worry-Free Business Security ServicesTrend Micro Titanium Internet Security
 
RAN4056TRAN4052T
Trend Micro Apex OneTrend Micro Deep Discovery Web InspectorDDI Rule ID: 597 – “PsExec tool detected”DDI Rule ID: 1847 – “PsExec tool detected – Class 2″DDI Rule ID: 4524 – “Possible Renamed PSEXEC Service – SMB2 (Request)”DDI Rule ID: 4466 – “PsExec Clones – SMB2 (Request)”DDI Rule ID: 4571 – “Possible Suspicious Named Pipe – SMB2 (REQUEST)”DDI Rule ID: 4570 – “COBALTSTRIKE – DNS(RESPONSE)”DDI Rule ID: 4152 – “COBALTSTRIKE – HTTP (Response)”DDI Rule ID: 4469 – “APT – COBALTSRIKE – HTTP (RESPONSE)”DDI Rule ID: 4594 – “COBALTSTRIKE – HTTP(REQUEST) – Variant 3″DDI Rule ID: 4153 – “COBALTSTRIKE – HTTP (Request) – Variant 2″DDI Rule ID: 2341 – “COBALTSTRIKE – HTTP (Request)”DDI Rule ID: 4390 – “CobaltStrike – HTTPS (Request)”DDI Rule ID: 4870 – “COBEACON DEFAULT NAMED PIPE – SMB2 (Request)”DDI Rule ID: 4861 – “COBEACON – DNS (Response) – Variant 3″DDI Rule ID: 4860 – “COBEACON – DNS (Response) – Variant 2″DDI Rule ID: 4391 – “COBEACON – DNS (Response)”
Trend Micro Apex OneTrend Micro Deep Security Trend Micro Worry-Free Business Security ServicesTrend Micro Titanium Internet SecurityTrend Micro Cloud EdgeTroj.Win32.TRX.XXPE50FFF071

Trend Micro XDR uses the following workbench alerts to protect customers from Rhysida-related attacks:

Cobalt Strike

Workbench AlertID
Anomalous Regsvr32 Execution Leading to Cobalt Strike63758d9f-4405-4ec5-b421-64aef7c85dca
COBALT C2 Connectionafd1fa1f-b8fc-4979-8bf7-136db80aa264
Early Indicator of Attack via Cobalt Strike0ddda3c1-dd25-4975-a4ab-b1fa9065568d
Lateral Movement of Cobalt Strike Beacon5c7cdb1d-c9fb-4b1d-b71f-9a916b10b513
Possible Cobalt Strike Beacon45ca58cc-671b-42ab-a388-d972ff571d68
Possible Cobalt Strike Beacon Active Directory Database Dumping1f103cab-9517-455d-ad08-70eaa05b8f8d
Possible Cobalt Strike Connection85c752b8-93c2-4450-81eb-52ec6161088e
Possible Cobalt Strike Privilege Escalation Behavior2c997bac-4fc0-43b4-8279-6f2e7cf723ae
Possible Fileless Cobalt Strikecf1051ba-5360-4226-8ffb-955fe849db53

PsExec

Workbench AlertID
Possible Credential Access via PSEXESVC Command Execution0b870a13-e371-4bad-9221-be7ad98f16d7
Possible Powershell Process Injection via PSEXEC7fe83eb8-f40f-43be-8edd-f6cbc1399ac0
Possible Remote Ransomware Execution via PsExec47fbd8f3-9fb5-4595-9582-eb82566ead7a
PSEXEC Execution By Processe011b6b9-bdef-47b7-b823-c29492cab414
Remote Execution of Windows Command Shell via PsExecb21f4b3e-c692-4eaf-bee0-ece272b69ed0
Suspicious Execution of PowerShell Parameters and PSEXEC26371284-526b-4028-810d-9ac71aad2536
Suspicious Mimikatz Credential Dumping via PsExec8004d0ac-ea48-40dd-aabf-f96c24906acf

SILENTKILL

Workbench AlertID
Possible Disabling of Antivirus Software64a633e4-e1e3-443a-8a56-7574c022d23f
Suspicious Deletion of Volume Shadow Copy5707562c-e4bf-4714-90b8-becd19bce8e5

Rhysida

Workbench AlertID
Ransom Note Detection (Real-time Scan)16423703-6226-4564-91f2-3c03f2409843
Ransomware Behavior Detection6afc8c15-a075-4412-98c1-bb2b25d6e05e
Ransomware Detection (Real-time Scan)2c5e7584-b88e-4bed-b80c-dfb7ede8626d
Scheduled Task Creation via Command Line05989746-dc16-4589-8261-6b604cd2e186
System-Defined Event Logs Clearing via Wevtutil639bd61d-8aee-4538-bc37-c630dd63d80f

Trend Micro Vision One hunting query

Trend Vision One customers can use the following hunting query to search for Rhysida within their system:

processCmd:”powershell.exe*\\*$\?.ps1″ OR (objectFilePath:”?:*\\??\\psexec.exe” AND processCmd:”*cmd.exe*\\??\\??.bat”)

Source :
https://www.trendmicro.com/en_us/research/23/h/an-overview-of-the-new-rhysida-ransomware.html