The Abbott-Turnbull-Morrison Federal Government still hasn't made personal health data secure

Since about 2014 it has been known that the personal details of Medicare cardholders has been for sale on the dark web.

Despite an April 2014 report by the Australian National Audit Office that the Consumer Directory - which contains all Medicare customer records - was not secure and that cardholder details were for sale, the federal Liberal-Nationals Coalition Government does not appear to have comprehensively acted act on the issue of database security.

It was not unknown that Medicare cardholder details were being used fraudulently.

In 2016-17 Twenty notifications, involving 123 separate breaches, resulted from findings under the Medicare compliance program. In these instances, certain Medicare claims made in the name of a healthcare recipient but not by that healthcare recipient were uploaded to their My Health Record.

When contacted by the mainstream media in July 2017 the Liberal MP for Aston and then Minister for Human Services Alan Tudge denied any prior knowledge of cardholder details being offered for sale.

It was not reported that at the time if he was asked about instances of Medicare cardholder details being used to commit fraud or identity theft.

In August 2017 eHealth Privacy Australia was telling the Senate Finance and Public Administration Committee that:

• There are fundamental weaknesses in both the HPOS (Medicare card data) and My Health Records systems, which make them vulnerable to illegal access.

• Those weaknesses mean that fraudulent users of the systems can assume the identity of legitimate users to gain illegal access.

• It is not sufficient to mitigate these weaknesses in the My Health Records system.

By 1 January 2019 IT News was reporting that Medicare cardholder details fraudulently obtained had been used to access an individual’s My Health Record:

The number of data breaches involving the My Health Record system rose from 35 to 42 in the past financial year, new figures show.

The Australian Digital Health Agency (ADHA) said in its annual report [pdf] that “42 data breaches (in 28 notifications) were reported to the Office of the Australian Information Commissioner” in 2017-18.

As with previous years, the agency said that “no purposeful or malicious attacks compromising the integrity or security of the My Health Record system” were reported in the period.

Of the 42 breaches, one was the result of “unauthorised access to a My Health Record as a result of an incorrect Parental Authorised Representative being assigned to a child”, the agency reported.

A further two breaches were from “suspected fraud against the Medicare program where the incorrect records appearing in the My Health Record of the affected individual were also viewed without authority by the individual undertaking the suspected fraudulent activity”, ADHA said.

In addition, 17 breaches were the result of “data integrity activity initiated by the Department of Human Services to identify intertwined Medicare records (that is, where a single Medicare record has been used interchangeably between two or more individuals)”, the agency said. [my yellow highlighting]

Despite this knowledge the Abbott-Turnbull-Morrison Government has still not grasped the nettle, because on 16 May 2019 The Guardian reported:

Australians’ Medicare details are still being illegally offered for sale on the darknet, almost two years after Guardian Australia revealed the serious privacy breach.

Screenshots of the Empire Market, provided to Guardian Australia, show the vendor Medicare Machine has rebranded as Medicare Madness, offering Medicare details for $US21.

Other vendors charge up to $US340 by offering fake Medicare cards alongside other fake forms of identification – such as a New South Wales licence.

The Medicare Madness listing suggests the Medicare details “of any living Australian citizen” have been available since September 2018.

Guardian Australia first reported patient details were on sale in July 2017, verifying the listing by requesting the data of a Guardian staff member and warning that Medicare card numbers could be used for identity theft and fraud.

The revelation prompted a review lead by former secretary of the Department of Prime Minister and Cabinet Peter Shergold.

The report did not identify the source of the Medicare data leak but suggested that people could use publicly available information about healthcare providers – including their provider number and practice location – to pass security checks and obtain a Medicare card number through the Department of Human Services provider hotline.

The review panel warned the “current security check for release of Medicare card information provides a much lower level of confidence than the security requirements” for Health Professional Online Services, the portal that allows providers to make rebate claims.

An IT industry source, who refused to be named, said the re-emergence of the data breach brings into question government assurances around the privacy of medical data “when those responsible cannot even manage the security of Medicare cards”.

The source said there is a “concerted effort at the moment by law enforcement to curtail darknet market activity”.

“In reality the darknet markets, while disrupted momentarily when their sites are brought down, easily relocate and continue business.”

Darknet markets can simply private message existing clients with a new link to resume business elsewhere. [my yellow highlighting]

Thus far the federal government has failed to recognise where Medicare cardholder details may be being accessed unlawfully, as this 2 August 2018 ABC online article indicates:

Privacy experts have warned that the system opens up health records to more people than ever before, thereby increasing the threat surface — the number of vulnerabilities in a system — dramatically.

Dr Bernard Robertson Dunn, who chairs the health committee at the foundation, says once the data is downloaded into the health system, the My Health record system cannot guarantee privacy.

"Once the data has been downloaded to, for instance, a hospital system, the protections of the hospital system apply, and then the audit logs apply to the hospital system — not to My Health record.

"So there is no way the Government would know who has accessed that data, and it is untraceable and untrackable that that access has occurred."