The scale-up of evidence-based innovations (EBIs) in criminal legal and other settings remains understudied, significantly diminishing their potential impact on public health. This innovative comparative effectiveness trial will test two promising interventions for scaling up EBIs: policy levers and multisite provider learning collaboratives, to increase the use of medications for opioid use disorders (MOUDs) across 12 states and 120 prisons. The increased use of MOUD in prison settings could save an estimated 1,800 lives annually.