votes, including the process by which MACPAC discloses recommendations for such a recusal. . (d) Application (1) Duties The amendments made by subsection (a) (other than the amendments made by paragraph (5) of such subsection) shall apply with respect to reports (and recommendations included in reports) submitted on or after the date that is more than one year after the date of the enactment of this Act. (2) Guidance The amendments made by subsection (a)(5) shall apply with respect to guidance issued on or after the date of the enactment of this Act. (3) Membership (A) Appointment of new members The Comptroller General of the United States shall apply the changes to the membership of the Medicaid and CHIP Payment and Access Commission required by amendments made by subsection (b) as soon as is practicable, consistent with subparagraph (B), and in no event later than the date that is three years after the date of the enactment of this Act. (B) Retention of current members An individual who is a member of the Medicaid and CHIP Payment and Access Commission as of the date of the enactment of this Act may continue to serve until the end of the individual’s term as of such date without regard to the amendments made by subsection (b). (4) Conflicts of interest The amendment made by subsection (c) shall apply beginning on the date that is 90 days after the date of the enactment of this Act.