If I want to file a claim in 2 states, does my lawyer need to be licensed in both states?

If your claim could potentially be filed against the same person or entity in both states, you are going to have to pick which state you want to file your claim in.  If you were treated by two different doctors for the same injury or ailment, but in two different states, then you can sue each doctor in his respective state.  With that in mind, regardless of how you decide file your med mal claim, the attorney representing you must be licensed in each state where the attorney intends to represent you.  So if you want to file a lawsuit in NE and Iowa, you need to find an attorney that is licensed in both states.  There are some potential exceptions, however.  One is for your attorney to make an application to the state in which he is not licensed to see if they will grant the attorney limited permission to come in and represent you on this isolated matter.  This is called Admission Pro Hac Vice.  This exception tends to be rare, but is available in both of the states that you list.  Another option is to hire a boutique type law firm that specializes in medical malpractice claims and have multi-state offices.  Essentially, the local lawyer will take your information and generally “manage” your case.  However, another member of the firm who is licensed in another state will be the lead attorney for pleadings in the second state.  Even though it’s tempting to hire an attorney that is unfamiliar with the rules of another state, it can actually end up costing you more in the long run if the attorney does not understand the rules of that state and how to maximize those rules for the best settlement of your claim.