Medication non-adherence is a costly problem in the US healthcare system, costing over $300 billion annually and contributing to hospital and nursing home admissions. Seniors are especially at risk due to taking multiple medications and increased risk of adverse drug events. Pharmacists can play an active role in improving medication adherence through programs that have increased compliance from below 60% to over 97% with improved health outcomes and reduced costs. New technologies now available can help pharmacists monitor patient medication adherence and safety. Rules need to allow pharmacists to utilize these technologies and take a leading role in medication adherence programs.