Establishes audit and payment requirements for pharmacy benefit managers.

S 464 requires pharmacy benefit managers (PBMs) to pay or deny pharmacy claims within 14 days of receipt, or provide written notice of denial. It mandates PBMs to update pricing information for generic and brand drugs weekly, provide clear access to reimbursement formulas, and establish dispute resolution processes. The bill also grants health plans and the state Department of Banking and Insurance the right to audit PBM records and requires PBMs to disclose conflicts of interest. This directly affects PBMs, pharmacies, and health insurers by increasing transparency and accountability in prescription drug reimbursement.