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IT and Security Guidance for Ohio Practices

Steel packing table in a mail order pharmacy with blank white shipping envelopes and amber prescription bottles, a network switch's green lights glowing on a shelf behind

Patient Data on the Website: How a Pharmacy Lost 258,920 Records Without a Network Break-In

Ridgeway Pharmacy's internal systems were never touched. The personal and health information of 258,920 customers leaked from its public website, which a third party designed and built. What a practice website can end up holding, and five questions for whoever built and hosts yours.

Read more: Patient Data on the Website: How a Pharmacy Lost 258,920 Records Without a Network Break-In

Open steel key cabinet with rows of brass keys in a dim server closet, a rack's green status lights out of focus behind it

The Keys Behind the Apps Your IT Provider Connects to Microsoft 365

On October 15, one compromised credential for a backup app that IT providers install in their clients' Microsoft 365 was used to sign in to at least 173 tenants, Huntress says, with no password and no multi-factor prompt. Microsoft now assesses that a China state-aligned group, Storm-0940, was responsible. What the app's access reaches, and five questions to ask whoever manages your tenant.

Read more: The Keys Behind the Apps Your IT Provider Connects to Microsoft 365

Small black device spliced between two network cables on a server shelf, one green light on

The Phish Your Email Filter Will Never See: Why MFA Alone Is Not Stopping Microsoft 365 Takeovers

Modern phishing kits relay your staff through the real Microsoft sign-in page and walk away with the session token, so the email filter, and even multi-factor authentication, never see the compromise. What it costs a small firm, and five fixes for whoever runs your Microsoft 365 tenant.

Read more: The Phish Your Email Filter Will Never See: Why MFA Alone Is Not Stopping Microsoft 365 Takeovers

Fountain pen beside a blank sheet of paper on a walnut desk, a laptop behind it

One Click, Two Problems: The Phish That Steals Your Mailbox and Installs Remote Control

Security researchers at ANY.RUN tracked a phishing campaign they call CSuite across 351 sandbox analyses, and just over half of those submissions came from the United States. The lures are the documents your office handles every day: a DocuSign envelope, an Adobe file, a Zoom invite, a Dropbox share. One of them was a forged signature request sent in a law firm's name. What sets this campaign apart is what a single click leaves behind. Not one problem, but two.

Why a password reset does not fix it

The first problem is the mailbox. The lure pushes the victim into a Microsoft 365 sign-in, sometimes by asking them to type a short code into Microsoft's real login page. The victim signs in for real and completes multi-factor authentication for real. The attacker's waiting software collects the session tokens that come out the other end. Multi-factor checks the moment of sign-in; the tokens issued afterward are an already-trusted session, and replaying them opens the mailbox with no second prompt. Nothing in your logs shows a failed password attempt, because no password was ever guessed. Resetting the password does not end a session that is already live.

The second problem is the computer. In one case the lure delivered a small script that elevated its own permissions and installed ScreenConnect, a genuine remote-management product that IT departments buy and use. Action1, another real product, is used in the campaign as well. The software is signed by its vendor, registers itself as a normal Windows service, and calls home to the vendor's own cloud, which many firms already allow through their firewall. Antivirus generally does not flag it, because it is not malware. It is a legitimate remote-control tool that now belongs to someone else.

That is why the cleanup is two separate jobs. Revoke the stolen session and the attacker still has the remote-control agent. Remove the agent and the attacker still has the mailbox. Close only one and you have left a door open.

What it costs a small firm

An attacker reading a live executive or finance mailbox sees the supplier you already pay, the amount you already owe, and the tone your controller already uses. A message asking to update remittance details arrives mid-thread from the correct sender, and accounts payable approves it because every prior signal checks out. Money leaves under a legitimate approval, which limits what your bank can reverse and starts your insurer asking what controls failed.

The damage then moves outward. Compromised accounts get used to phish colleagues, partners, and clients from your real domain, with your real email authentication passing. Explaining to a client that their staff clicked on something that came from you tends to reach the commercial relationship.

The campaign's exposure clustered in technology, manufacturing, government, and consulting, but the mechanics are generic. A dental practice, a law office, and an accounting firm all run on supplier payment chains and client correspondence, and all three sign documents electronically.

The practical takeaway

Five things, in order. The first three are for whoever manages your Microsoft 365 tenant.

  1. When an account is suspected, revoke its sessions in Entra ID and force sign-in on every device, before anything else. The session is the access path; the password reset comes second.
  2. Take an inventory of remote-access tools on every machine and keep exactly one that your IT provider actually uses. Block the others from running, and block their vendor domains at your web filter, so a dropped installer fails at the download step.
  3. Run three mailbox checks in the same hour: inbox rules that file messages mentioning invoices, wires, or remittance into odd folders; forwarding addresses, including ones set at the admin level; and recently approved third-party apps, which keep reading mail after you revoke sessions.
  4. Give executives, finance approvers, and administrators phishing-resistant multi-factor, meaning a hardware security key rather than a code or an approve button. There is no code to relay and no prompt to approve by mistake.
  5. Make any change to payment details require a phone call to a number you already have on file. This single habit defeats the fraud even when the mailbox is already in someone else's hands.

And one sentence for staff: a signature request you were not expecting is a phone call, not a click.

For regulated firms, notification obligations commonly follow what the attacker could reach, not what you can prove they took. An executive mailbox holds employee records, client personal data, and whatever else passed through it. Knowing whether you could reconstruct what was read is worth checking before you need to.

The full breakdown, including the exact indicators your IT provider should hunt for, is in our Threat Intelligence Center write-up. If you are not sure which remote-access tools are installed across your firm right now, a security assessment will produce that list.

Empty conference room after hours, a blank wall-mounted screen glowing at the far end

The Phishing Attack That Uses Microsoft's Real Login Page

Microsoft has taken down EvilTokens, a phishing service that broke into more than 12,000 Microsoft 365 mailboxes at more than 10,000 organizations, including healthcare, financial services, construction, and real estate firms. The victims did not type their password into a fake page. They typed a short code into Microsoft's real login page, approved their own multi-factor prompt, and handed a criminal their mailbox. Here is how that works, and what a small firm on Microsoft 365 should change this week.

Why multi-factor did not stop it

Microsoft 365 has a legitimate sign-in method for devices that cannot show a login page, like conference room screens and smart TVs. The device displays a short code, and you enter it on Microsoft's own website to link the device to your account. EvilTokens generated those codes on the attacker's side and sent them to victims in tailored phishing messages. The victim went to the genuine Microsoft page, entered the code, and completed multi-factor authentication normally, because it really was their own sign-in. The access token that came out the other end went to the criminal.

Nothing about that looks wrong to the victim or to a basic security review. The password is never captured and never changes. Multi-factor succeeds. And because the platform kept refreshing that token in the background, a password reset alone did not evict the intruder. The mailbox could show no failed logins and no password change while someone else read it every day.

What the AI part actually did

EvilTokens was a subscription product: $1,500 to sign up and $500 a month for a dashboard, sold on Telegram. Its selling point was an "analyst" chatbot that read each compromised mailbox and worked out who approves payments, which vendor relationships carry trust, and which invoices were in flight. It then recommended who to impersonate and helped draft the fraudulent message, written from real conversations in the style the recipient already expects.

That is ordinary business email compromise, the fake "our bank details have changed" invoice, made available to buyers with no skill at it. It also retires the advice most staff training still gives. Bad grammar, a generic greeting, or odd branding are no longer reliable warning signs, because the message is built from your own correspondence and sent from a real colleague's real account.

The industries hit had nothing in common except mailboxes that contained payment conversations. For a practice, a law firm, or an accounting office, that describes most of the partners and the whole billing department.

The practical takeaway

Five changes for whoever manages your Microsoft 365 tenant.

  1. Block the device-code sign-in method for everyone who does not need it. In Entra ID, a Conditional Access policy can deny that flow across the tenant, with a small exception group for the conference room devices that actually use it. This removes the mechanism EvilTokens depended on.
  2. When an account is suspected, revoke its sessions, not just its password. A password reset leaves an already issued token working until it expires on its own. Revoking the account's sign-in sessions is what ends it.
  3. Look at your sign-in logs once, filtered for device-code authentication. In most small firms the answer should be zero or a handful of known devices. Anything else needs an explanation.
  4. Check for inbox rules that move or delete messages mentioning invoices, payments, or wire transfers. Mailbox fraud commonly hides the real vendor's replies this way.
  5. Make payment-detail changes require a phone call to a number you already have on file, never one from the email. That single habit defeats the fraud even when the mailbox is already compromised.

Tell staff one rule, too: if a message gives you a code and asks you to enter it on a Microsoft sign-in page, do not enter it. A real device code is shown on the screen of the device in front of you.

For regulated firms there is one more consideration. Once attacker tooling has read a mailbox, the client correspondence, patient messages, or payroll threads inside it count as exposed whether or not any payment was redirected, and notification obligations commonly attach to that exposure. Knowing whether you could tell which mailboxes were read is worth checking before you need to.

The full breakdown, including the detection signals your IT provider should alert on, is in our Threat Intelligence Center write-up. If you are not sure whether device-code sign-in is open in your tenant, a security assessment will tell you.

More Articles …

  1. One Click, No Attachment: The Zero-Day Chain That Beat an Up-to-Date Browser
  2. The Biggest Patch Tuesday Ever: What 999 Fixes Mean for a Small Firm
  3. When Your Own Microsoft 365 Becomes the Attacker's Channel
  4. Half of 2025's Attacks Never Touched the Endpoint

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