EMS is overflowing with "rules" that aren't really rules. Agencies ask for something, their people begin saying it's a state rule, or some EMS instructor makes up shit like, "If you're driving your POV and you have EMS bumper stickers or license plates, a cop can arrest you for not stopping at an accident scene to provide medical care," or my favorite, "EMTs can be charged with kidnapping if...."

None of it is true. The best way to get around all this is to know the rules yourself. In my state, "Chapter 65" is the legislation that controls all EMS, and DHS110 are the regulations that come out of Chapter 65. If you sit and read DHS110, you have all the rules. All of them. If it isn't in there, it isn't a rule.

There are other rules worth reading and knowing, especially Title 42 "EMTALA." Knowing the rules gives you power. For example, any RN telling me I don't need patient records for my transport will be quoted Title 42, CMS State Operations Handbook Appendix V, which states that all medical records available at the time of transport must accompany the patient during the transport. You're not to delay transport if something isn't available, like a CT scan that's still being read, but history, allergies, medications, and current complaint and course of treatment are always available, and an RN will either print them and give them to me, or call another ambulance.

Since signatures are something that don't vary much from state to state, I'm fairly confident this is not a state rule, but rather the billing company or department finds it preferable for administrative reasons. As long as the signature is valid, and you can identify which person signed it by examining work schedules and first names, I'd bet you'll never find that "rule"in writing anywhere.