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SmileCDR HAPI FHIR EUVDEUVD-2026-108276

| CVE-2026-113876 MEDIUM
Incorrect Authorization (CWE-863)
2026-10-22 cisa-cg GHSA-xwm2-wwv7-wrr5
5.3
CVSS 4.0 · Vendor: cisa-cg
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Attack ChainAIDerived

Hypothetical attack flow derived from CVE metadata – not a confirmed exploit chain

  1. Access
    Authenticate with CREATE-only permission
  2. Exploit
    Craft conditional create with matching predicate
  3. Execution
    Server returns matched resource contents
  4. Impact
    Disclose unauthorized FHIR data

Vulnerability Assessment

Weakness
CWE
OWASP Top 10:2025
A01:2025 - Broken Access Control
ASVS 5.0
V8 - Authorization Authorization logic validation
MITRE ATT&CK

1 technique across 1 tactic: Privilege Escalation

The technique list with ATT&CK links and the kill-chain view is part of the Basic plan and up.

Exploitation Conditions

Exploitation requires an authenticated SmileCDR/HAPI FHIR user account that holds the CREATE permission but lacks READ permission on the target data, and the use of the FHIR conditional create operation with a search predicate the attacker constructs to match an existing resource. The disclosure only occurs when that predicate matches an already-existing resource. Limiting factors: the attacker must already possess valid low-privilege credentials with CREATE rights (PR:L - not remote-unauthenticated), and must be able to formulate a predicate that matches the target resource, so blind data exfiltration is constrained by how guessable or enumerable the matching search criteria are.

Impact

This is a genuine but moderate-severity authorization flaw, not a drop-everything emergency. The supplied CVSS 4.0 vector (AV:N/AC:L/AT:N/PR:L/UI:N/VC:L/VI:N/VA:N) scores 5.3 and is internally consistent with the description: network-reachable, low attack complexity, but requiring low privileges (PR:L) - specifically an authenticated account that already holds CREATE permission. Impact is confidentiality-only and rated Low (VC:L), reflecting that the leak is limited to the contents of a resource whose matching predicate the attacker can already construct, not a bulk database read. No EPSS score, CISA KEV listing, or PoC/exploit reference was provided, so there is no public exploit identified at time of analysis and no evidence of active exploitation. The vuln.today decision label is 'this_month' (not act_now/emergency), aligning with the moderate score and absence of exploitation signals. The clearest tension in the input is the 'Authentication Bypass' tag versus the actual mechanism: CWE-863 (Incorrect Authorization) and the description both describe an authorization/permission-model failure by an already-authenticated user, not an authentication bypass - verify categorization before routing. Overall: a real, patch-worthy authorization/data-exposure bug warranting scheduled remediation, not crisis response.

Exploit ScenarioDerived

An attacker who holds a valid SmileCDR/HAPI FHIR account with CREATE but not READ permission issues a conditional create request whose search predicate is crafted to match an existing resource they are not authorized to read. Because the conditional-create authorization path does not enforce READ permission, the server returns the matched target resource's contents, disclosing data the user should not see. No public exploit code was identified in the provided sources.

This Month Plan within 30 days. Why: MEDIUM severity (CVSS 4.0-6.9).
No patch listed yet

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AnalysisAIv1 – Oct 22, 2026

SmileCDR HAPI FHIR contains a moderate-severity authorization bypass in the FHIR conditional create operation: an authenticated user with CREATE but not READ permission can receive the contents of an existing resource when the conditional create predicate matches it. Exploitation requires valid low-privilege credentials and a predicate that successfully identifies the target resource, so disclosure is constrained by how guessable or enumerable the search criteria are. No public exploit was identified at time of analysis; the supplied priority is this_month.

RemediationAI

No vendor-released patch or fixed version is identified in the available data at time of analysis. While waiting for a vendor fix, restrict the CREATE permission so users cannot hold CREATE without READ on the same FHIR resource types, and disable the conditional create operation for resource types where it is not required; these controls can break legitimate client workflows that rely on conditional create or broad CREATE rights, so scope them narrowly. Review SmileCDR/HAPI FHIR audit logs for conditional create requests that returned existing resources to users lacking READ, and monitor the CISA CSAF advisory and CVE record for updated remediation guidance.

Affected VersionsENISA

HAPI FHIR 0 <September 2026

Affects your stack

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Checking this CVE against your own stacks and servers is part of the Basic plan and up.

Technical ContextAI · show details

The issue is in SmileCDR's HAPI FHIR server implementation of FHIR conditional create, where a client submits a create request with a search predicate used to determine whether a matching resource already exists. The server is supposed to search for a match and either create a new resource or return the existing one, but it performs the authorization decision on the CREATE permission without enforcing READ on the matched resource, which is CWE-863 (Incorrect Authorization). The supplied CPE cpe:2.3:a:smilecdr:hapi_fhir:*:*:*:*:*:*:*:* does not define a version range, so the precise affected releases are not stated in the available data. Both the CVSS 4.0 vector and the independent CVSS 3.1 assessment use AV:N/AC:L/PR:L/UI:N, confirming a network-reachable, authenticated low-privilege attack with no user interaction; the trigger is a conditional create predicate that matches an existing resource, and the sources do not describe any further preconditions.

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Severity by source

Vendor (cisa-cg) PRIMARY 5.3 MEDIUM
CVSS:4.0/AV:N/AC:L/AT:N/PR:L/UI:N/VC:L/VI:N/VA:N/SC:N/SI:N/SA:N
vuln.today AI 4.3 MEDIUM

Network FHIR endpoint with low complexity; PR:L because a valid CREATE-permitted account is required; confidentiality-only Low impact (leak limited to matched resource), no integrity or availability effect.

3.1 AV:N/AC:L/PR:L/UI:N/S:U/C:L/I:N/A:N
4.0 AV:N/AC:L/AT:N/PR:L/UI:N/VC:L/VI:N/VA:N/SC:N/SI:N/SA:N

Primary rating from Vendor (cisa-cg).

CVSS VectorVendor: cisa-cg

Attack Vector
Network
Attack Complexity
Low
Attack Requirements
None
Privileges Required
Low
User Interaction
None
Vulnerable system: Confidentiality
Low
Vulnerable system: Integrity
None
Vulnerable system: Availability
None
Subsequent system: Confidentiality
None
Subsequent system: Integrity
None
Subsequent system: Availability
None

DescriptionCVE.org

SmileCDR HAPI FHIR does not correctly check authorization for conditional create actions. A user with CREATE but not READ permissions could submit a conditional create whose predicate matches an existing resource and receive the target resource's contents.

Threat Intelligence Overview

Prevalence
Medium
HAPI FHIR / Smile CDR common in healthcare interoperability, industry-specific not universal
Data Quality
4 sources
Confidence: Medium

How this decision was reached

The engine reads each signal below and applies a fixed list of rules from top to bottom. The first rule that matches sets the recommended action – like a statement, every line is shown.

SignalValue
Severity MEDIUM
CISA KEV No
Public POC No
EPSS N/A
Patch available No
Active threat No
Deciding rule
MEDIUM severity (CVSS 4.0-6.9)
What every action level means
Emergency Immediate action required. Criteria: CRITICAL + in CISA KEV (actively exploited) without patch, OR CRITICAL + EPSS > 30% without patch, OR CRITICAL + active threat signals without patch.
Act Now Prioritize within 24-48h. Criteria: in KEV with patch available, OR CRITICAL + public POC, OR HIGH + EPSS > 10%, OR CRITICAL + active threat, OR any CRITICAL severity.
This Week Schedule remediation this week. Criteria: HIGH severity (CVSS 7.0-8.9). Patch within normal change window.
This Month Plan within 30 days. Criteria: MEDIUM severity (CVSS 4.0-6.9), lower exploitation probability. Include in regular patch cycle.
Monitor Track and reassess. Criteria: LOW severity (CVSS 0.1-3.9), minimal exploitation risk. No immediate action needed.

SSVC AssessmentENISA

SSVC Decision· derived
Scheduled
Exploitation
None
System Exposure· derived
Open
Automatable
No
Human Impact· derived
Medium
Technical Impact
Partial

Priority Score

26
Low Medium High Critical
KEV: 0
EPSS: 0
CVSS: +26
PoC: 0
Weaponized: 0
Threat intel: 0
Gov advisory: 0

Attack Technique

Authentication bypass attacks exploit flaws in the verification mechanisms that control access to systems and applications.

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