Security readout for executives and security teams
Plain-English summary
OpenEMR versions before 8.0.0 allowed any authenticated API client to access or change patient document and insurance data beyond its assigned permissions. This affects protected health information and can create confidentiality and integrity risk even without administrator access.
Executive priority
Prioritize remediation for any healthcare environment using OpenEMR REST APIs. The issue directly affects PHI confidentiality and data integrity, requires only authenticated API access, and has a vendor patch in version 8.0.0.
Technical view
The REST route table in `apis/routes/_rest_routes_standard.inc.php` omitted `RestConfig::request_authorization_check()` for document and insurance routes. Other patient routes used ACL checks. The issue is CWE-862 missing authorization, with CVSS 8.1, network access, low complexity, and low privileges required.
Likely exposure
Organizations running OpenEMR before 8.0.0 with REST API clients or bearer tokens are potentially exposed. The issue requires a valid API bearer token, so exposure centers on authenticated integrations, users, or compromised tokens.
Exploitation context
The provided sources do not report active exploitation, and the CVE is not marked KEV. Abuse would require authenticated API access, but successful abuse could expose or modify every patient’s documents and insurance data regardless of configured OpenEMR ACLs.
Researcher notes
Evidence is limited to the CVE record, GitHub advisory, and patch commit. The advisory states all document and insurance PHI could be accessed or modified by any valid API bearer token before 8.0.0. No public exploitation evidence is provided in the supplied sources.
Mitigation direction
- Upgrade OpenEMR to version 8.0.0 or later.
- Review the GitHub advisory and vendor guidance for deployment-specific instructions.
- Inventory API clients and bearer tokens with OpenEMR access.
- Rotate or revoke unnecessary API tokens after upgrading.
- Review access logs for unusual document or insurance API activity.
Validation and detection
- Confirm the deployed OpenEMR version is 8.0.0 or later.
- Identify any OpenEMR instances still running versions before 8.0.0.
- Verify document and insurance REST routes enforce authorization checks.
- Check whether API integrations use bearer tokens against affected endpoints.
- Review logs for broad patient document or insurance access by low-privilege clients.
Public sources used
Generated from the cited source records. This long-tail analysis has not been individually reviewed by a named human.
Conservative CVE-to-ATT&CK context
These mappings and lookup hints may be relevant to the vulnerability behavior, CWE, affected product, or exposure path. Glexia-inferred context is not an official MITRE, ATT&CK, CWE, or CVE Program mapping.
ATT&CK lookup starting points
Use these exact CWE pages and searches to review the Glexia ATT&CK library from this CVE's weakness and description context.
CWE-862: Authorization and privilege behavior lookup
Authorization weaknesses can support privilege escalation and valid-account review, depending on exploit path. Open the exact CWE lookup page first, then review the ATT&CK searches from that MITRE weakness context. This is a Glexia lookup hint, not an official ATT&CK mapping.
Open ATT&CK lookupCredential and access behavior lookup
The CVE wording references authentication or credential exposure, so valid-account and credential-access review may help. This is a Glexia inferred lookup path, not an official MITRE, ATT&CK, or CVE Program mapping.
Open ATT&CK lookupCVE-2026-25164 mapping review
Open the CVE-to-ATT&CK bridge for reviewed, inferred, or future official mappings tied to this CVE.
Open ATT&CK lookup- Severity
- High
- CVSS
- 8.1 (3.1)
- Known Exploited
- No
- Published
Vector: CVSS:3.1/AV:N/AC:L/PR:L/UI:N/S:U/C:H/I:H/A:N
CNA and ADP enrichment extracted from CVE v5
These fields come from the CVE record and ADP containers, not from Glexia's Take. They preserve time-varying source decisions such as CISA SSVC, KEV status, CVSS metrics, and provider references.
CVSS vector scores
1 official scoreWe collect every scored CVSS vector available in the official CNA and ADP containers. When more than one version is present, the table keeps the source vectors side by side instead of collapsing them into the highest score.
CVSS:3.1/AV:N/AC:L/PR:L/UI:N/S:U/C:H/I:H/A:N2.85.2Primary CVE scoreVulnerability scoring details
Base CVSS 3.1 score
8.1HighVector: CVSS:3.1/AV:N/AC:L/PR:L/UI:N/S:U/C:H/I:H/A:N
Source materials
- CVE List V5 sourceCVE List V5
- https://github.com/openemr/openemr/security/advisories/GHSA-f64c-h2gh-g3f9CVE reference · x_refsource_CONFIRM
- https://github.com/openemr/openemr/commit/c5e1c44774156cd0d04f4e08ed6a81fe76d38e92CVE reference · x_refsource_MISC
Products and packages named in the record
CWE details
CWE links open Glexia weakness intelligence pages with official CWE context, developer remediation guidance, and related CVE mappings.
Missing Authorization
Missing Authorization represents a recurring weakness pattern that can create exploitable paths when design, validation, or implementation controls are missing.