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Compliance with Stark laws
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Dickson Consulting
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Outline of Stark laws related to medical devices
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Transforming the Business of Oncology Through Science and Technology
Transforming the Business of Oncology Through Science and Technology
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PYA, P.C.
Have you structured your hospital-based physician contracts to address all aspects of compliance? Hospitalist agreements involve unique compliance and financial issues, particularly when global payments and advanced practice providers are involved. Risks include indirect compensation, billing and other compliance issues. This presentation will discuss compliance risks and provide guidance on how to structure compliant contracts and business arrangements.
Compliance and Legal Risks in Laborist, Surgicalist, and Hospitalist Arrangem...
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PYA Principal Tynan Kugler and Consulting Manager Susan Thomas presented “Auditing Healthcare Focus Arrangements for Regulatory Compliance: Physicians, Management Services, Post-Discharge Care, Ambulance Services, and Specialty Care.” Their presentation: - Describes what constitutes a focus arrangement for healthcare organizations. - Explains the implications of Stark Law and Anti-Kickback violations, along with Corporate Integrity Agreement focus arrangement requirements. - Discusses essential focus arrangement procedures to facilitate regulatory compliance. - Provides an example design of an audit plan approach for focus arrangements.
Auditing Healthcare Focus Arrangements for Regulatory Compliance
Auditing Healthcare Focus Arrangements for Regulatory Compliance
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The article discusses the importance of the insurance eligibility verification process and the different steps involved.
Insurance eligibility verification – steps to reduce claim denials
Insurance eligibility verification – steps to reduce claim denials
Outsource Strategies International
Interpace Diagnostics Group Presentation
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Catholic Healthcare Stark Presentation
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osmalegal
PYA Principal Jim Lloyd, along with other presenters, provided a “Healthcare Valuation 101” during a pre-conference workshop at the 2013 AICPA Healthcare Industry Conference.
PYA Presents Intro to Healthcare Valuation
PYA Presents Intro to Healthcare Valuation
PYA, P.C.
PYA’s Tynan Olechny and Valerie Rock presented “How to Have a Successful Engagement and a Happily Ever After: ‘New Age’ Nuances to Physician Hospital Arrangements” with R. Ross Burris III of Polsinelli at the Health Care Compliance Association’s (HCCA) Regional Annual Conference.
How to Have a Successful Engagement and a Happily Ever After: “New Age” Nuanc...
How to Have a Successful Engagement and a Happily Ever After: “New Age” Nuanc...
PYA, P.C.
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Transforming the Business of Oncology Through Science and Technology
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PYA, P.C.
Have you structured your hospital-based physician contracts to address all aspects of compliance? Hospitalist agreements involve unique compliance and financial issues, particularly when global payments and advanced practice providers are involved. Risks include indirect compensation, billing and other compliance issues. This presentation will discuss compliance risks and provide guidance on how to structure compliant contracts and business arrangements.
Compliance and Legal Risks in Laborist, Surgicalist, and Hospitalist Arrangem...
Compliance and Legal Risks in Laborist, Surgicalist, and Hospitalist Arrangem...
MD Ranger, Inc.
PYA Principal Tynan Kugler and Consulting Manager Susan Thomas presented “Auditing Healthcare Focus Arrangements for Regulatory Compliance: Physicians, Management Services, Post-Discharge Care, Ambulance Services, and Specialty Care.” Their presentation: - Describes what constitutes a focus arrangement for healthcare organizations. - Explains the implications of Stark Law and Anti-Kickback violations, along with Corporate Integrity Agreement focus arrangement requirements. - Discusses essential focus arrangement procedures to facilitate regulatory compliance. - Provides an example design of an audit plan approach for focus arrangements.
Auditing Healthcare Focus Arrangements for Regulatory Compliance
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The article discusses the importance of the insurance eligibility verification process and the different steps involved.
Insurance eligibility verification – steps to reduce claim denials
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Outsource Strategies International
Interpace Diagnostics Group Presentation
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osmalegal
PYA Principal Jim Lloyd, along with other presenters, provided a “Healthcare Valuation 101” during a pre-conference workshop at the 2013 AICPA Healthcare Industry Conference.
PYA Presents Intro to Healthcare Valuation
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PYA’s Tynan Olechny and Valerie Rock presented “How to Have a Successful Engagement and a Happily Ever After: ‘New Age’ Nuances to Physician Hospital Arrangements” with R. Ross Burris III of Polsinelli at the Health Care Compliance Association’s (HCCA) Regional Annual Conference.
How to Have a Successful Engagement and a Happily Ever After: “New Age” Nuanc...
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PYA Principal Tynan Olechny and Senior Manager Annapoorani Bhat provided important information for rural providers related to fair market value and commercial reasonableness considerations during a National Rural Health Association webinar, “Valuations: What Rural Providers Need to Know."
Fair Market Value: What Rural Providers Need to Know
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PYA, P.C.
PYA Principal Jim Lloyd was among the faculty who spoke at the 2013 Mid-South Commercial Law Institute during a panel discussion on “Healthcare Facilities in Bankruptcy.” The presentation provided an overview of healthcare facilities and key issues, healthcare regulatory environment, valuation of healthcare facilities, and red flags for healthcare businesses in bankruptcy or distress.
Panel Discusses Healthcare Facility Bankruptcy
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PYA, P.C.
During an AHLA webinar series roundtable discussion, “Guarding Your Client’s Valuation from Attack—Dos and Don’ts for Requesting, Reviewing, Using, and Discarding FMV Opinions,” PYA Principal Carol Carden joined other legal experts to explore the practical issues for counsel to consider when balancing the arguments for scrutinizing valuation reports with the arguments for ensuring valuator independence.
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To hear the recorded version of this webinar, visit http://bit.ly/1JqXkox Our panel discusses developments in government enforcement of health care anti-fraud laws. This will include recent court decisions, settlements and OIG/DOJ pronouncements and public statements. The focus will be on development in 2015 year to date. The panel will also discuss significant "cases to watch" that are in active litigation and could result in decisions that impact the industry. On our agenda: Overview of recent government enforcement efforts Highlight of significant False Claims Act decisions in 2015 Discussion of pending cases and their implications for the industry Presenters: Jeffrey Fitzgerald, Shareholder, Polsinelli Brian Bewley, Shareholder, Polsinelli
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PPSA is a new act... recently passed in USA. To monitor the culture between pharma companies and doctors like receiving incentives ,gifts and prescribing those companies drugs Due to this act , people will be more safer with drugs and healthcare cost burden will reduced...and to know more about act... see the presentration..
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PYA Consulting Principal Carol Carden co-presented with Charlene McGinty of McKenna Long. They examined the top issues to address when acquiring a physician practice and some of the common and more complex issues hospitals face during the acquisition.
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Health insurance companies use the pre-authorization process to verify whether a drug, procedure or service prescribed is medically necessary.
How to Get Medical Pre-approval or Prior Authorization Effectively
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The Physician’s Sunshine Act will impose changes in the way that healthcare meeting planners manage data and reporting. Disclosure of payments for Transfer of Value (TOV) will soon be required and violations for non-compliance can lead to stiff penalties and other ramifications for you and your organization. Find out from meeting experts what they are doing to prepare for the new regulations for transparency and accountability.
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PYA Principal Jim Lloyd co-presented with PYA colleague Anna Bhat at the NACVA and Consultants Training Institute’s (CTI) Advanced Healthcare Valuation and Consulting Symposium, December 12-13, 2014, on the topic, “Evaluating the Brand Value of Healthcare Entities,” providing a comprehensive overview regarding: Healthcare affiliations in which “brand” is a key factor. Detailed discussion regarding healthcare entity brands. Methodologies commonly used to value brands. Evaluating a healthcare entity’s brand strength. Capitalizing on your entity’s brand.
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Government enforcement actions against health care companies are increasing. The Department of Justice has recovered more than $2 billion in health care false claims cases in each of the last five years. In 2014, the DOJ recovery was $2.3 billion. Health care fraud is an issue for any company that deals in health care, as well as for private equity firms, lenders, and underwriters. Winston health care partners Tom Mills and Marion Goldberg led an informative eLunch on what you should be aware of if you are involved in health care. Topics included: • Current government focus • Recent enforcement actions • What you should be alerted to if you are a health care company • What to look for in the diligence process if you are investing, financing, or underwriting a health care company
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This File helps to understand the part of US healthcare Medical billing concept.
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Chris Carnahan, President of Carnahan Group, presented at the National Association of Certified Valuators and Analysts' (NACVA) Advanced Valuation: Applications and Models Workshop on December 6, 2016. The presentation covers valuing physician practices; specifically,fair market valuations (FMVs) in healthcare, the government regulations surrounding FMVs, the current trends and marketplace, as well as valuing physician compensation.
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Tutorial presented at the 2014 Drug Information Association (DIA) Annual Meeting in Philadelphia, on June 26. 3-hour lecture focused on details of: * Statutory Provisions * The Regulations * How CMS Is Construing Sunshine – Selected Q&A
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OIG This presentation highlights the importance of regulatory requirements and the consequences of non-compliance for healthcare organizations that deal with physician arrangements. Addresses regulatory considerations such as the Stark Law, Anti-Kickback Statute, and False Claims Act. Explores additional risk areas such as OIG Fraud Alerts, Medicare Cost Report Certification, and the responsibilities of boards of directors.
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PYA Principal Jim Lloyd was among the faculty who spoke at the 2013 Mid-South Commercial Law Institute during a panel discussion on “Healthcare Facilities in Bankruptcy.” The presentation provided an overview of healthcare facilities and key issues, healthcare regulatory environment, valuation of healthcare facilities, and red flags for healthcare businesses in bankruptcy or distress.
Panel Discusses Healthcare Facility Bankruptcy
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During an AHLA webinar series roundtable discussion, “Guarding Your Client’s Valuation from Attack—Dos and Don’ts for Requesting, Reviewing, Using, and Discarding FMV Opinions,” PYA Principal Carol Carden joined other legal experts to explore the practical issues for counsel to consider when balancing the arguments for scrutinizing valuation reports with the arguments for ensuring valuator independence.
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To hear the recorded version of this webinar, visit http://bit.ly/1JqXkox Our panel discusses developments in government enforcement of health care anti-fraud laws. This will include recent court decisions, settlements and OIG/DOJ pronouncements and public statements. The focus will be on development in 2015 year to date. The panel will also discuss significant "cases to watch" that are in active litigation and could result in decisions that impact the industry. On our agenda: Overview of recent government enforcement efforts Highlight of significant False Claims Act decisions in 2015 Discussion of pending cases and their implications for the industry Presenters: Jeffrey Fitzgerald, Shareholder, Polsinelli Brian Bewley, Shareholder, Polsinelli
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"The Stark Law 2019: Good Things on the Horizon for Providers"
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PPSA is a new act... recently passed in USA. To monitor the culture between pharma companies and doctors like receiving incentives ,gifts and prescribing those companies drugs Due to this act , people will be more safer with drugs and healthcare cost burden will reduced...and to know more about act... see the presentration..
Physician Payment Sunshine Act(PPSA)
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PYA Consulting Principal Carol Carden co-presented with Charlene McGinty of McKenna Long. They examined the top issues to address when acquiring a physician practice and some of the common and more complex issues hospitals face during the acquisition.
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Health insurance companies use the pre-authorization process to verify whether a drug, procedure or service prescribed is medically necessary.
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The Physician’s Sunshine Act will impose changes in the way that healthcare meeting planners manage data and reporting. Disclosure of payments for Transfer of Value (TOV) will soon be required and violations for non-compliance can lead to stiff penalties and other ramifications for you and your organization. Find out from meeting experts what they are doing to prepare for the new regulations for transparency and accountability.
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PYA Principal Jim Lloyd co-presented with PYA colleague Anna Bhat at the NACVA and Consultants Training Institute’s (CTI) Advanced Healthcare Valuation and Consulting Symposium, December 12-13, 2014, on the topic, “Evaluating the Brand Value of Healthcare Entities,” providing a comprehensive overview regarding: Healthcare affiliations in which “brand” is a key factor. Detailed discussion regarding healthcare entity brands. Methodologies commonly used to value brands. Evaluating a healthcare entity’s brand strength. Capitalizing on your entity’s brand.
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Medical insurance fraud is generally defined as knowingly executing a treatment to render medically unnecessary or over-utilizing services that result in useless costs to the healthcare system, including health insurance providers
Health insurance fraud presentation
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Government enforcement actions against health care companies are increasing. The Department of Justice has recovered more than $2 billion in health care false claims cases in each of the last five years. In 2014, the DOJ recovery was $2.3 billion. Health care fraud is an issue for any company that deals in health care, as well as for private equity firms, lenders, and underwriters. Winston health care partners Tom Mills and Marion Goldberg led an informative eLunch on what you should be aware of if you are involved in health care. Topics included: • Current government focus • Recent enforcement actions • What you should be alerted to if you are a health care company • What to look for in the diligence process if you are investing, financing, or underwriting a health care company
Health Care Fraud, Will I Know It When I See It?
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This File helps to understand the part of US healthcare Medical billing concept.
Ama prepare that claim taking an active approch to the claims management re...
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Rajinikanth Dhakshanamurthi
Chris Carnahan, President of Carnahan Group, presented at the National Association of Certified Valuators and Analysts' (NACVA) Advanced Valuation: Applications and Models Workshop on December 6, 2016. The presentation covers valuing physician practices; specifically,fair market valuations (FMVs) in healthcare, the government regulations surrounding FMVs, the current trends and marketplace, as well as valuing physician compensation.
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Evaluating the Brand Value of Healthcare Entities
Evaluating the Brand Value of Healthcare Entities
Health insurance fraud presentation
Health insurance fraud presentation
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Health Care Project Overview from H2kInfosys LLC
Health Care Fraud, Will I Know It When I See It?
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Ama prepare that claim taking an active approch to the claims management re...
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Healthcare Quality Policy and Law Chapter 12 1 Chapter Overview (1 of 2) Discusses licensure and accreditation in the context of healthcare quality Describes the scope and causes of medical errors Describes the meaning and evolution of the medical professional standard of care Identifies and explains certain state-level legal theories under which healthcare professionals and entities can be held liable for medical negligence Chapter Overview (2 of 2) Explains how federal employee benefits law often preempts medical negligence lawsuits against insurers and managed care organizations Describes recent efforts to measure and incentivize high-quality health care Quality Control Through Licensing and Accreditation (1 of 3) Licensing of healthcare professionals and institutions is an important function of state law, as it filters out those who may not have the requisite knowledge or skills to practice medicine State licensure laws define the qualifications required to become licensed and the standards that must be met for purposes of maintaining and renewing licenses Quality Control Through Licensing and Accreditation (2 of 3) Historically, licensing has been used in the promotion of healthcare quality in only the bluntest sense. This is because the only method by which to promote quality through licensure is the granting or denial of the license to practice medicine—no real middle ground. Private professional and industry ethical and practice standards exist, though their effect on day-to-day quality is debatable. State licensing schemes were designed not with healthcare quality per se in mind, but rather with an eye toward protecting the medical professions from unscrupulous or incompetent providers and bad publicity. 5 Quality Control Through Licensing and Accreditation (3 of 3) Licensure plays an important role in defining the permissible “scope of practice” of the various types of healthcare providers. It is one thing for state legislators to define the meaning of practice for various broad medical fields, but quite another for legislators to define, for example, the lawful activities of doctors as compared to physician assistants as compared to nurses. 6 Medical Errors (1 of 3) Although medical errors are not a new problem, framing the issue as a public health problem is a relatively new phenomenon. Overall, more people die each year from medical errors than from motor vehicle accidents, breast cancer, or AIDS. Medical Errors (2 of 3) Causes of medical errors may include the failure to complete an intended medical course of action, implementation of the wrong course of action, use of faulty equipment or products in effectuating a course of action, failure to stay abreast of one’s field of medical practice, health professional inattentiveness, the fact that optimal treatments for many illnesses are not yet known, and the culture of medicine itself. Medical Errors (3 of 3) Policy makers have begun shifting their ...
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Chapter 2 Fraud and Abuse: Stark/Physician Self-Referral and Anti-Kickback Learning Objectives Physician Self-Referral (Stark) Law and Anti-Kickback Statute (AKS) Services, individuals, organizations, and transactions affected by these laws. Specific behaviors prohibited. Exceptions and “safe harbors” for avoiding liability. Anticipating and preventing violations. Physician Self-Referral Law (Stark) Initial law (Stark I) sponsored by Congressman Pete Stark enacted in 1989 and applied only to clinical laboratory services. Omnibus Budget Reconciliation Act of 1993 (Stark II) expanded law to additional 10 types of clinical services. Patient Protection and Affordable Care Act of 2010 added restrictions on physician-owned hospitals and required the issuance of a self-referral disclosure protocol. Stark Prohibition “... If a physician (or an immediate family member of such physician) has a financial relationship with an entity ..., then the physician may not make a referral to the entity for the furnishing of designated health services for which payment otherwise may be made” under Medicare (also applicable to Medicaid). (underlining added). “Physician” The person making the referral may be a(n) MD Osteopath Dentist Podiatrist Optometrist, or Chiropractor “Immediate family member” Besides the referring physician herself, this person may be a spouse; parent, child, or sibling (by birth or adoption); stepparent, stepchild, step-brother, or step-sister; father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law; grandparent or grandchild; or spouse of a grandparent or grandchild. “Entity” The entity with which there is a financial relationship must be one that bills CMS for designated health services (DHS) or that furnishes all or most of the components of the DHS. This includes the person or entity that actually performs the DHS, or presents a claim for DHS services to the Medicare program. 7 “Financial relationship” Direct or indirect ownership of an entity: Equity stock, interest in a limited liability company, holding debt in an entity. Direct or indirect compensation from an entity: Physician’s compensation from an entity, lease between physicians and health care facilities, medical director agreements, and independent contract with physicians. “Designated health services” (I) Clinical laboratory services. Physical therapy services. Occupational therapy services. Outpatient speech-language pathology services. Radiology and certain other imaging services. Radiation therapy services and supplies. “Designated health services” (II) Durable medical equipment and supplies. Parenteral and enteral nutrients, equipment, and supplies. Prosthetics, orthotics, and prosthetic devices and supplies. Home health services. Outpatient prescription drugs. Inpatient and outpatient hospital services. Penalties for Stark Violations Payment for services in response to prohibited referral must ...
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PYA Principal Shannon Farr led a presentation titled, “Fair Market Value and Physician Compensation,” in which she discussed current trends and hot topics in the healthcare industry, including an overview of healthcare regulatory considerations, hospital-physician alignment and physician affiliation models, and trends relating to physician compensation.
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PYA Principal Jim Lloyd along with Polsinelli’s Douglas Anning presented “Doing the Deal” in which they utilized case studies in analyzing both hospital-hospital transactions and hospital-physician practice transactions. The presentation also covered: Helping clients successfully negotiate and structure the transaction and keeping the deal on track Recognizing sample contract provisions common to these types of deals Working with valuation firms to ensure the transaction terms are within fair market value and commercially reasonable Evaluating and dealing with potential anti-trust concerns Dealing with potential compliance issues identified during the due-diligence process
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The recent American Health Lawyers Association’s 2013 Tax Issues for Healthcare Organizations conference offered valuable information related to healthcare industry reform and resulting tax implications and compliance. PYA Senior Manager Susan Clark presented “Strategies for More Tax-Effective Physician Practice Acquisition Transactions.” The discussion included: Transaction options Key issues with buyers and sellers Personal vs. enterprise goodwill considerations Corporate practice of medicine doctrine Allocations
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PYA Principal Carol Carden co-presented “Forensic and Valuation Issues in Healthcare” at the AICPA Forensic & Valuation Services Conference in New Orleans, LA, November 10, 2014.
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PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
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On May 8, 2024, Marel hosted an investor meeting where Arni Sigurdsson CEO and Sebastiaan Boelen CFO gave an overview of the financial results and operational highlights in the first quarter.
Marel Q1 2024 Investor Presentation from May 8, 2024
Marel Q1 2024 Investor Presentation from May 8, 2024
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Marel Q1 2024 Investor Presentation from May 8, 2024
Marel Q1 2024 Investor Presentation from May 8, 2024
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