There are lots of things you will need to do to stay certified, including LLSA during the first four years after certification, MyEmCert during subsequent years, and statements of improving practice and professionalism. All of these steps cost over a thousand dollars per decade of practice.
ABEM is cosponsoring a new certification for hospital administration. The initial requirements are to have an MBA and to work in healthcare leadership. I'm sure that the exam will cost another thousand dollars, which is ridiculous for someone who already has an MBA and leadership experience.