Cybercriminals are ramping up attacks on health care systems throughout the United States, with a majority of these crimes originating from international, state-sponsored bad actors. In this conversation, John Riggi, national advisor for cybersecurity and risk at the AHA, talks with Oliver E. Rich, Jr., assistant director of the FBI’s International Operations Division, about the unique ways the bureau operates across the globe, and the essential role that diplomacy and cooperation play in making sure America's essential services are safe and secure.

Tom Haederle

Many Americans believe that the world's most elite law enforcement agency, our own Federal Bureau of Investigation, has a purely domestic charter and operates only within the borders of the United States. That's not completely accurate. While it's true the FBI cannot issue subpoenas, conduct investigations, or make arrests overseas without consent from the host country, it does have an international operations division of nearly 100 offices around the world that monitors and works to mitigate the kinds of crimes and threats that don't respect borders.

Tom Haederle

And in this age of rampant cybercrime, their presence is more important than ever.

Tom Haederle

Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA communications. The rise in devastating cyber attacks directed against hospitals by state-sponsored bad actors remind us that America's interests can be assaulted from anywhere and must be defended everywhere. In this podcast hosted by John Riggi, AHA’s National Advisor for Cybersecurity and Risk, we hear from an Oliver Rich, assistant director for the FBI's International Operations Division about the unique ways the Bureau operates in host countries and the essential role that diplomacy and cooperation play in working together to block or deflect criminal activity.

John Riggi

A.D. Rich, Oliver, if I may. You've had a very interesting and highly distinguished career in the FBI, and many young men and women still dream of becoming an FBI agent. Could you tell us your path to the FBI? What drew you to the FBI in a career in law enforcement? And how did you prepare yourself for the highly competitive process for selection to the most elite law enforcement agency in the world?

Oliver E. Rich, Jr.

Again, thank you very much for the opportunity. Good to be with you. And thank you for the question. You know that it's never lost on me, that you know the incredible opportunity that I have working for the FBI. I can say that, you know, I've met some people in my career that have thought about being an FBI agent their entire life.

Oliver E. Rich, Jr.

Right? And that's always been their dream. That's not particularly my story. When I was a kid, my father was in the Air Force and he was an Air Force mechanic. And he used to talk about all the planes and the aircraft and the jets and things like that when I was a kid. And so as a kid, I grew up wanting to be a pilot, and that's pretty much was my dream until I went off and joined the Navy and became a pilot in the Navy.

Oliver E. Rich, Jr.

When I left the Navy, my wife was in the military as well. And when, you know, we had kids and, you know, life was changing and those kinds of things. I did happen to meet a guy one time when I was stationed in Memphis, Tennessee. He was an FBI pilot, and he started talking with me about the FBI.

Oliver E. Rich, Jr.

Took me over to the FBI building. Showed me around. And, you know, we talked about it, and I was like, man, that'd be an interesting career. As I was getting out of the Navy. I ended up going to the airlines. And then 9/11 happened, and I didn't forget about my experience and my exposure to the FBI.

Oliver E. Rich, Jr.

But also, you know, being an airline pilot. Great job. I mean, it really is a great job. You know, you can have a lot of fun, go all over the world and stuff like that. A really, really enjoyable job. I just thought that there was more service to be done and I reflected on my conversations with not only that FBI agent, but another FBI agent that I met when I was in the Navy.

Oliver E. Rich, Jr.

And so they talked with me about, you know, the amount of service or the kind of service that I could have as an agent. And it really just piqued my interest. And particularly after 9/11, you know, I talked to my wife and I said, I think, I think I want to do this. So I reached out to an agent that I knew from the military, and, he helped to recruit me and get me into the FBI.

Oliver E. Rich, Jr.

And so it's been a it's been a great career. I think, you know, that a lot of the things that in my past and in my, in my career before coming into the FBI kind of fit well with, with the FBI, the military background, it's not just about military folks. I was really proud of our class that we had so many different people with backgrounds from a range of industries, including banking and finance and accounting and teachers.

Oliver E. Rich, Jr.

Oliver E. Rich, Jr.

And I think that was the backbone of really most of us and why we did that. I'll tell you when I took the test, when I took the test for the FBI, you know, I thought I failed it. It was a lot of math on that test. And I was like, there's no way I passed that test. I'm just going to go back and take my airline job.

Oliver E. Rich, Jr.

But it really made me want it more. I am that kind of person that if you tell me I can't do something, then I'm like, I would double-down and I want to do a lot more. So when I thought I didn't pass a written test, I was like, oh my gosh, you know, I could not fail this test.

Oliver E. Rich, Jr.

But I got the letter. I found out later that they didn't care about the math. They're really just trying to work me up to, you know, for the really important part, which is what kind of person are you, what kind of character you have? Are you driven? Also just being that, you know, type A personality, a lot of us are where we want to get 100% on everything.

Oliver E. Rich, Jr.

You know, I think I was ready for the academy, I think I was ready for the career. And, you know, I was very, very pleased to be able to work with some of the some of the best people that I've, I've got a chance to meet in my lifetime.

John Riggi

Thanks for that background, Oliver. It's interesting how you talk about one meeting with someone who takes an interest in a young person to help mentor and guide them can change their entire lives. In the fact that you, being present in the Bureau has helped the Bureau become better as well. So these, you know, as I've learned, you know, I spent 28 years in the Bureau, you know, and been out for a retired eight years now.

John Riggi

And I think back of, all the folks that helped me and mentored me in my career and steered me in the right direction. And there is a personality type goes to the Bureau. Be the best - as soon as you attach elite to anything, that's what we want. But I realize now, at this stage in my life, that some of the most important things that I do involve mentoring young folks, helping them realize their fullest potential.

John Riggi

And thank goodness that person - thank goodness for the nation and the FBI - they took that time with you, Oliver. Let's talk current tense right now. Tell us about your current role. Extremely fascinating that most folks don't realize the FBI has an international mission. You're not just a domestic law enforcement agency and domestic, national security agency. The FBI absolutely is international in scope.

John Riggi

Talk to us about your global responsibilities as head of the FBI's International Criminal National Security Investigation and Operations that you oversee. And, maybe you can talk to us about what authorities the FBI does or does not have overseas as well.

Oliver E. Rich, Jr.

The kinds of issues and threats that we deal with as a nation today obviously do not respect borders, right? And so the FBI, many, many years ago saw this as something that we you know, saw the international, aspects to crime and to national security as something that we needed to be able to have a presence and be able to work from overseas standpoint.

Oliver E. Rich, Jr.

So as far back as in the 40s, I think our first office that the FBI established was in, Bogota in Colombia. And then we set up some additional sites in Mexico. And the program sort of expanded. But today, International Operations Division, we have about 65 legats and another 30 legal attache offices offices.

Oliver E. Rich, Jr.

where we have a senior FBI agent assigned along with the team, as well as we have some offices around 32. So we have about 98, you know, 90, 97, 98 offices around the world. The staff with about 350 people. And we cover about 180 countries, in international operations division. And our goal is to be a good partner with our foreign partners, with our international partners, to help mitigate threats of national security, to help mitigate threats of, from a criminal aspect, whether it's transnational organized crime or crimes against children.

Oliver E. Rich, Jr.

We have agents stationed all over the world to help mitigate and manage these threats and risks. For the most part, 99% of the time we don't have any authorities overseas to act except for the authority and the power of our foreign partners. So, so much of what we do is just based on relationships. It's based on the fact that we are talking with like minded countries, for the most part, to have an interest in mitigating the same types of threats that we have an interest in.

John Riggi

So, Oliver, fascinating what you're describing here, how many different countries that you cover. And I think one of the key points you mentioned is that everything that is a national security threat or internet organized crime, major crimes are international in scope these days. And certainly part of the reason for that is the internet. People are able to including the bad guys, communicate much more efficiently and develop global relationships, which unfortunately is turned into global criminal and national security threats.

John Riggi

As you indicated, the FBI has no unilateral authority. You just can't handle a agency or a foreign entity, a subpoena or a search warrant you've got to work at through cooperation. So that's really what I found amazing when I was dealing with the legats when I had the privilege to be overseas for a little bit as well.

John Riggi

Speaking about being overseas: recently I had the opportunity to provide a keynote presentation at a very large European cybersecurity conference with the head of your FBI Rome office, your legal attache, Chris Flowers, just did an amazing job. We discussed recent joint international cyber law enforcement disruptions. Could you briefly tell us about some of those, such as the Lockbit in the hive ransomware group disruptions and how you work with allied foreign law enforcement agencies?

John Riggi

Finally, does the private sector play a role in those disruptions?

Oliver E. Rich, Jr.

Yeah. Thanks again, for your question, and thank you for attending the event over there. I mean, I know there was a there was a lot of people are huge event. And, we were very fortunate to be able to, take part in, with, with our, our legal attache, Chris Flowers over there, who's representing the Bureau extremely well in Rome with all our partners.

Oliver E. Rich, Jr.

Look at, you know, cyber is one of those things like I said earlier, there is no borders here, right? And, so these are huge problems that we face within our cyber division. In the FBI in general, you know, part of our strategy is to one: identify and disrupt cyber networks wherever they are in the world.

Oliver E. Rich, Jr.

And so we have to work very closely with our international partners, and also with, with our domestic partners as well. To do this is I mean, these are, very challenging threat actors. They present numerous, numerous areas where we have difficulty in tracking and figuring out who they are. But we are working very hard to, number one, remove their anonymity of these actors.

Oliver E. Rich, Jr.

So, you know, remove that cloud that they have around them and who they are and identify them and publicly name them through indictments and things like that. And so we want to do that. We want to be able to get onto their networks. We want to be able to disrupt their networks, and then we want to be able to impose consequences where a lot of these folks are working in terms of, ransomware, you know, the money, the financing, how do we get that?

Oliver E. Rich, Jr.

Can we get into their wallets? And can we can we take that, take those funds back and make this a game that is not necessarily one that they're willing to take the chances enacting. And so, Lockbit and HIVE are two examples of that, where the FBI and other partners around the world have been really successful in taking down infrastructure, getting on infrastructure, identifying who the actors were and imposing consequences

Oliver E. Rich, Jr.

in terms of the financing. When you mentioned the private sector and how they might be engaged and how they might help. Number one, we really, really need to continue to need the private sector to come forward and to share information about when they're hit with ransomware attacks, to help identify the threat actors tactics, their procedures, and also sort of what they're looking for and in terms of where the ransoms are being paid. We need that information it helps us conduct our investigations, and it also helps us to do joint and sequence operations with our partners around the world, identifying crypto wallets and working through these chains to see where the

Oliver E. Rich, Jr.

money actually lands. We have some very, very smart people that work on that. And we, you know, our cyber division, along with, the other agencies we work with in that space, you know, they're working very hard to impose consequences on these threat actors in that area, but super, super excited about what we did with Lockbit and HIVE to take down Lockbit ransomware as a service and malware as a service.

Oliver E. Rich, Jr.

If you got briefings on this, you'd be surprised about how easy it is to deploy some of this ransomware as a as a service or malware as a service to, to deploy this material. And it is a problem that is going to continue to grow, which is why we have to work internationally with partners. All around the world to combat it.

John Riggi

Certainly, we understand from the hospital perspective the threat that ransomware groups pose to us and as a nation. Ransomware attacks on U.S hospitals and health systems continue to disrupt and delay healthcare delivery, posing a risk to patient safety. And, we've had hospitals from very large systems experiencing attacks currently to very small, remote rural hospitals that serve 500 square miles.

John Riggi

And suddenly they have to go on ambulance diversion. These are just truly life-threatening issues. And we're glad to see the FBI attempting to impose risk and consequences. Take the money out of the equation. Help them - the bad guys - understand that ultimately if you the attack a hospital, it's not an economic crime, it's a threat to life crime and that they face serious risk and consequences for that. Oliver from all of from Europe

John Riggi

global law enforcement intelligence perspective, what do you see as the emerging global threats, cyber and otherwise? What should we be watching for in health care and in general here in the US?

Oliver E. Rich, Jr.

So I look, I think that, you know, the problems that we've seen in the past are still with us. Right? And so if you think about transnational organized crime, those problems are still with us, and they're going to remain a problem for us for quite some time. Counterterrorism, you know, those problems still with us, but technology and sort of changing methods and tactics and these kinds of things make these challenges a lot more difficult.

Oliver E. Rich, Jr.

Let's talk about CT, for example, I'll go back to the medical system in a minute. But from a counterterrorism perspective, if you think about the ease with which people move around the world today and how that might create additional risk for terrorism to act, or the widespread use of drones and those kinds of things, and what a drone can be used for today.

Oliver E. Rich, Jr.

Years ago, you know, we didn't have to worry about drones so much. Now, what someone can do with a drone and how drones are used and automation and these kinds of things are present much more of a challenge. And so as technology continues to move and create the different ways for people to deploy criminal and national security threats, we still have to keep watching out for that, right?

Oliver E. Rich, Jr.

When it comes to fraud. And if you look at health care and these kinds of issues, so fraud, ransomware attacks, we just talked about how ransomware as a service was going to continue to be a problem. Malware, these kinds of cyber threats are going to continue to be a problem. Fraud itself and the ability for people to use computer generated images and messaging in order to commit fraud, whether it's healthcare fraud or, or just, you know, stealing money from people who have saved, spent their entire life saving up a nest egg.

Oliver E. Rich, Jr.

And now somebody comes along and uses AI generated technology to commit fraud. So these are all problems that I think are just going to require us to be a lot more vigilant, a lot more understanding of what these trade issues are. Gonna require a lot more outreach and engagement, which the FBI is doing, a whole lot more outreach and engagement to educate people.

Oliver E. Rich, Jr.

So we're trying to stop crime and events from happening in the first place before we ever get to the investigation piece. How do we help people identify threats on their own and so they become less vulnerable? And how do you identify risk for hospitals? And so you become less vulnerable.

John Riggi

And as you mentioned, technology is the great enabler. However, it is an enabler for criminals as well. And as technology continues to evolve, so will the attack vectors, whether it's national security threats, criminal threats, and of course cyber threats as well. AI of course, we're watching that very closely in health care, the use of artificial intelligence in health care holds tremendous hope and promise to the point where AI may be used to discover cures for cancer, so forth.

John Riggi

As you mentioned, we're also seeing our adversaries use AI to generate highly effective malware to target hospitals and health care. So it's a double-edged sword at the moment. And again, clearly the cooperation, as you mentioned, between private sector and the FBI, especially in cyber matters, is vitally important. The evidence and intelligence related to cyber crimes lies on private sector networks, which comprise about 85% of all the networks in the United States.

John Riggi

And contrary to popular belief, and correct me if I'm wrong, Oliver, I don't think so, that the FBI just can't see into private sector networks without a warrant or cooperation. And, so the government doesn't see all that they need private sector cooperation.

Oliver E. Rich, Jr.

No, you're absolutely right about that. We definitely need the private sector to cooperate with us. We need the public in general. And this has been the lifeblood of the FBI for many years. Is is having the public help law enforcement help us in our national security mission to protect the United States. I mean, it is a whole of society, whole government approach to defend ourselves against the threats that we face.

Oliver E. Rich, Jr.

I mean, a wise person said, hey, you know, it might have been a general or famous general, but it takes a network to defeat a network, right? And so we have to build stronger networks and stronger partnerships and stronger relationships to work against the adversaries that we have in all of these different spaces. I mean, the one thing about the FBI and, you know, just go back to the first question you asked and what's attractive about the FBI is we work in so many different areas. So many different responsibilities in our portfolio, but it creates a challenge for us.

Oliver E. Rich, Jr.

Right? And we absolutely need the public. We need private sector partners. We need our law enforcement partners domestically and international to work with us, to make us more effective at addressing all these different, different issues that we have to face every day. In order for us to be the most effective and most capable as we can as a nation and as a global community,

Oliver E. Rich, Jr.

we have to be able to work together. We have to be willing to share information with one another that will help us. Number one, identify areas where we're vulnerable. And number two, come up with ways of hardening or mitigating those risks to us, either as an industry, as a community and as a nation.

John Riggi

Thank you, Oliver. I think you summed it up quite nicely. It's not just dependent on the private sector or the public to defend ourselves against these threats. The government can't do it without our cooperation. Whole of government is great. Absolutely. But as you said, it's a whole of nation approach, private sector, working with the government to defeat our common adversaries here, cyber and otherwise.

John Riggi

Thank you for being here with us today. Appreciate everything you do and all the men and women of the FBI to defend the nation against all physical and virtual and counterterrorist and all types of international crime. And thanks to all our listeners for tuning in and thank you for all our frontline health care heroes, for everything you do every day to care for patients and serve your communities.

John Riggi

This has been John Riggi, your national advisor for cybersecurity and risk. Stay safe everyone.

Tom Haederle

Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.