After 20 years, you have paid NREMT $200 in renewal fees; at 30 years, they have made $300 off you. If you are a paramedic, the numbers go up to $250 after 20 years, and $375 after 40. For that money, the least they can do is sending you a cert you can hang on your wall.
Considering most states require a state cert to practice, and simply maintaining your NR doesn't qualify (in most states, there are some that use the NR as the state cert, so don't jump on me for this), lately I have been questioning if it is working to maintain my NR. Now if they sent me a wall cert after 10 years, I would be more inclined to keep it, esp if my employer was paying the renewal fee.
Sorry for the tanget