`
`
`
`In the
`United States Court of Appeals
`For the Seventh Circuit
`____________________
`
`No. 21-1852
`NOREEN LANAHAN,
`
`COUNTY OF COOK,
`
`Plaintiff-Appellant,
`
`v.
`
`Defendant-Appellee.
`
`____________________
`
`Appeal from the United States District Court for the
`Northern District of Illinois, Eastern Division.
`No. 17-cv-5829 — Harry D. Leinenweber, Judge.
`____________________
`
`ARGUED FEBRUARY 17, 2022 — DECIDED JULY 20, 2022
`____________________
`
`Before ROVNER, HAMILTON, and ST. EVE, Circuit Judges.
`ST. EVE, Circuit Judge. Relator Noreen Lanahan was a long-
`time employee of Cook County’s Department of Public
`Health responsible for managing federal grants. After her re-
`tirement, Relator filed a qui tam suit against Cook County, al-
`leging various violations of the False Claims Act arising out
`of the use of federal grants. The district court dismissed Rela-
`tor’s Second Amended Complaint with prejudice, and Relator
`now appeals. We affirm.
`
`
`
`2
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`No. 21-1852
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`I. Background
`Appellant Noreen Lanahan (“Relator”) worked as a direc-
`tor of financial control in Cook County’s Department of Pub-
`lic Health (“CCDPH”), a certified public health department,
`from 1994 until her retirement in 2017. In this capacity, Rela-
`tor oversaw Cook County’s claim and reimbursement policies
`for hundreds of federal grants and crafted budgets submitted
`to the federal government in order to qualify for grant fund-
`ing. During this period, Cook County received approximately
`$20 million annually from the federal government for services
`related to federal public health priorities. Between 2008 and
`2017, Relator repeatedly warned Cook County it was seeking
`federal reimbursement for unincurred expenses. Relator iden-
`tifies four examples of Cook County’s purportedly fraudulent
`practices.
`A. 2009–11 H1N1 Influenza Grant
`In September 2009, the Centers for Disease Control and
`Prevention (“CDC”) awarded Cook County $2.5 million in
`federal grant funds to distribute the H1N1 vaccine. Prior to
`performing under the grant, Cook County prepared an antic-
`ipated budget. By regulation, Cook County could only be re-
`imbursed for costs associated with work actually performed
`under the grant. Instead, Relator asserts Cook County esti-
`mated the time dedicated to federal service after the fact and
`pinned the salary allocations submitted for reimbursement to
`the CDC to pre-performance budget estimates. Relator herself
`“never tracked [ ] federal service dedication,” never asked
`other managers how they apportioned employee time and
`was never solicited for an estimate of how individual employ-
`ees apportioned their time among federal and local service.
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`No. 21-1852
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`Indeed, Relator never tracked her own dedication to federal
`service.
`On September 1, 2011, Cook County submitted two Certi-
`fied Grant Allocation Cost Reports, one associated with the
`IDPH Pandemic Flu program and one with the IDPH Mass
`Vaccination program. Although the line-item shared ex-
`penses for each individual employee are identical, the IDPH
`Pandemic Flu expense report requested $1,065,506.05 in fed-
`eral reimbursement while the IDPH Mass Vaccination ex-
`pense report requested $1,210,802.33 in federal reimburse-
`ment. On September 26, 2011, the CDC transmitted reim-
`bursement vouchers to the Cook County Comptroller.
`Cook County was also required by regulation to segregate
`federal reimbursement funds from unaffiliated Cook County
`revenue. Upon receiving federal funds, Cook County submit-
`ted credit vouchers to apply the reimbursements to accounts
`in the CCDPH’s general ledger. On November 30, 2011, the
`Cook County Comptroller moved the H1N1 funds into a dis-
`cretionary account for the benefit of Cook County Health and
`Hospital Systems (“CCHHS”). Relator asserts this transfer
`“frustrated the allocations” in the September 1, 2011, report
`and “undermined any truth to the budget and compliance
`certifications” represented to qualify for and close out the
`grants.
`B. 2012–14 WIC Grant
`The Supplemental Nutrition Assistance Program
`(“SNAP”) for Women, Infants and Children (“WIC”) pro-
`vides supplemental nutrition, education, and healthcare to
`low-income citizens. Individual WIC grant business units oc-
`casionally retain positive balances at the end of the fiscal year
`
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`4
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`No. 21-1852
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`as a product of deferred personnel costs. By July 2014, Cook
`County had accumulated approximately $6.8 million in de-
`ferred WIC credits. In an email to Cook County’s Director of
`Grants Management, Relator explained the $6.8 million “pro-
`vides funding for Salaries and Fringe Benefits of grant em-
`ployees should current grants not be renewed” and the “de-
`ferred revenue rolls forward from the previous grant year and
`is adjusted at grant closing.” To avoid “distort[ing] current
`period grant expenses,” Relator opined the “funds need[ed]
`to be segregated by the use of a unique Cost Center.” Instead,
`Cook County opted to move the $6.8 million in deferred rev-
`enue into the general health fund of the CCHHS as, according
`to Cook County’s Chief Budget Officer, “[p]resumably these
`are expenses that were absorbed by the general/health fund
`when they occurred.” Relator asserts CCHHS did not itself
`incur any expense in connection with the WIC grants.
`C. Alleged Hektoen Kickback Scheme
`The Hektoen Institute of Medicine (“Hektoen”) is a non-
`profit fiscal agent that processes claims and collects reim-
`bursement revenue on behalf of Cook County for personal
`service costs incurred by Cook County physicians for federal
`grants. Hektoen did not have a formal agreement with Cook
`County but instead unofficially contracted with Cook County
`physicians in an “Exhibit A” package. Hektoen retained the
`only executed copies of these agreements, which Relator al-
`leges violated recordkeeping regulations. Hektoen submits
`claims upon and collects revenue from federal research grants
`on behalf of Cook County physicians in exchange for 10–15%
`of the awarded grant amount. Hektoen reallocated this col-
`lected revenue into a ”Dean’s Fund” and gave physicians
`“near autonomy” over the money.
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`No. 21-1852
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`In 2015, Hektoen collected and retained $5 million in re-
`stricted federal funds. Relator points to a 2018 Chicago Trib-
`une article detailing allegations against Dr. Bala Hota, a for-
`mer Cook County hospital physician, as an example of the
`problems with Hektoen’s practices. Dr. Hota allegedly em-
`bezzled almost $280,000 from Hektoen’s salary reallocation
`account, which he spent on personal expenses such as iTunes,
`luxury travel, and couture cupcakes.
`D. 2009–12 PHIMC Grant Management
`The Public Health Institute of Metropolitan Chicago
`(“PHIMC”) is a nonprofit fiscal agent. PHIMC is not a certi-
`fied health department. In 2010, the CDC awarded CCDPH
`$15.9 million as an up-front payment for services to be ren-
`dered during a two-year period of performance. In the fund-
`ing notice, the CDC limited funding to certified public health
`departments. The CCHHS Board approved PHIMC to serve
`as the fiscal agent for these funds. In June 2011, the CCHHS
`Board passed a resolution authorizing the transfer of grant
`funds to PHIMC, even though Relator alleges it had trans-
`ferred the funds previously. PHIMC lacked the resources and
`financial controls to qualify for the award independently and
`the CCDPH would have to account for the funds in an annual
`audit.
`E. Procedural History
`Relator filed an initial qui tam complaint alleging various
`violations of the False Claims Act (“FCA”), 31 U.S.C. § 3729 et
`seq. After investigating Relator’s allegations, the United States
`declined to intervene. Cook County moved to dismiss Rela-
`tor’s complaint for failure to state a claim under Rule 12(b)(6)
`and Rule 9(b). Instead of responding, Relator filed a First
`
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`No. 21-1852
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`Amended Complaint which differed very little from the ini-
`tial complaint. Cook County moved to dismiss the First
`Amended Complaint under Rule 12(b)(6) and Rule 9(b) as
`well.
`The district court dismissed Relator’s First Amended
`Complaint without prejudice in a thorough and detailed
`opinion. The chief deficiencies of Relator’s FCA claims were
`twofold. First, Relator failed to plead the submission of a false
`statement to the government, and certainly not with the par-
`ticularity required under Rule 9(b). Indeed, most of the activ-
`ities Relator described occurred after federal payments had
`been disbursed to Cook County. Second, Relator failed to al-
`lege any false claim for payment submitted by Cook County
`to the government. The district court observed accounting
`failures, procedural irregularities, and regulatory violations
`could not themselves give rise to an FCA claim.
`In response, Relator filed the operative Second Amended
`Complaint, alleging four causes of action under the FCA: a
`claim for presenting false claims for payment, in violation of
`31 U.S.C. § 3729(a)(1)(A) (Count I); a claim for use of false
`statements, in violation of 31 U.S.C. § 3729(a)(1)(B) (Count II);
`a claim for conversion, in violation of 31 U.S.C. § 3729(a)(1)(D)
`(Count III); and a claim for reverse false claims, in violation of
`31 U.S.C. § 3729(a)(1)(G) (Count IV). Again, Cook County
`moved to dismiss the Second Amended Complaint based on
`Rule 12(b)(6) and Rule 9(b).
`The district court dismissed the Second Amended Com-
`plaint with prejudice against Relator.1 The district court noted
`
`
`1 Initially, the district court dismissed the Second Amended Complaint
`with prejudice without specifying whether it pertained only to Relator or
`
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`No. 21-1852
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`7
`
`that, despite painstakingly explaining the Rule 9(b) pleading
`standard in its previous opinion, Relator failed to cure the de-
`ficiencies that warranted dismissal of the First Amended
`Complaint. The defects that doomed the Second Amended
`Complaint mirror those that doomed the First Amended
`Complaint. Specifically, with respect to Count I and Count II,
`Relator failed to adequately plead any false statements or
`claims, let alone any false statements connected with any gov-
`ernment payments. While Relator’s allegations surrounding
`the administration of the H1N1 grant reimbursement were
`more detailed, they nonetheless did not identify any specific
`falsities in the reports Cook County submitted. Even had Re-
`lator adequately pled a false statement, she did not link it to a
`government payment. The district court deemed Relator’s im-
`proper retention claims in Count III and Count IV inadequate
`because the Second Amended Complaint did not contain suf-
`ficient facts indicating Cook County had retained any funds
`that properly belonged to the government. Because Relator
`enjoyed two opportunities to amend her complaint, one with
`the benefit of the district court’s detailed assessment of the
`claims’ flaws, the district court dismissed the Second
`Amended Complaint with prejudice. The district court ob-
`served the Second Amended Complaint contained “the same
`mistakes” as Relator’s previous iteration, and these deficien-
`cies were “not small and provide th[e] Court with no indica-
`tion that Relator may be able to adequately plead an FCA
`claim in the future.” Relator now appeals the district court’s
`
`
`to the United States as well. The district court granted the government’s
`resultant motion to clarify the dismissal and specified the action was dis-
`missed with prejudice as to Relator but without prejudice as to the United
`States.
`
`
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`No. 21-1852
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`order dismissing the Second Amended Complaint with prej-
`udice.
`
`II. Discussion
`Relator presents two arguments on appeal.2 First, that the
`district court improperly dismissed her suit for failure to state
`a claim. Second, that the district court improperly did so with
`prejudice. Both arguments fail.
`The FCA imposes civil liability on a series of actions re-
`lated to fraudulent treatment of government funds. 31 U.S.C.
`§ 3729(a)(1). The Attorney General may bring suit under the
`FCA directly in the name of the United States. Id. at § 3730(a).
`Alternatively, a private citizen referred to as a “relator” may
`bring a qui tam action “in the name of the Government.” Id. at
`§ 3730(b)(1). If the qui tam action results in damages, the rela-
`tor shares in the award. See id. at § 3730(d).
`We review a district court’s dismissal of a complaint de
`novo, construing “all allegations and any reasonable infer-
`ences in the light most favorable to the plaintiff.” Jauquet v.
`Green Bay Area Catholic Educ., Inc., 996 F.3d 802, 807 (7th Cir.
`2021) (internal quotations omitted). Rule 12(b)(6) requires a
`complaint contain sufficient facts “to state a claim to relief that
`
`2 Although the district court did not enter a separate final judgment in this
`case per Federal Rule of Civil Procedure 58, we are nonetheless confident
`in our appellate jurisdiction. The district court clearly “indicated its intent
`to finally dispose of all claims,” Law Offices of David Freydin, P.C. v.
`Chamara, 24 F.4th 1122, 1128 (7th Cir. 2022), in dismissing the Second
`Amended Complaint with prejudice, expressly noting the “deficiencies in
`the [Second Amended Complaint] … provide this Court with no indica-
`tion that Relator may be able to adequately plead an FCA claim in the fu-
`ture.” The district court’s judgment is therefore final within the meaning
`of 28 U.S.C. § 1291. See id.
`
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`No. 21-1852
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`9
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`is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544,
`570 (2007).
`Claims arising under the FCA, an antifraud statute, are
`subject to Rule 9(b)’s heightened pleading standard. United
`States ex rel. Mamalakis v. Anesthetix Mgmt. LLC, 20 F.4th 295,
`301 (7th Cir. 2021). To state such a claim, Relator “must state
`with particularity the circumstances constituting fraud or
`mistake.” Fed. R. Civ. P. 9(b). To satisfy Rule 9(b)’s strictures,
`Relator must plead “the first paragraph of any newspaper
`story,” i.e., the “who, what, when, where, and how of the
`fraud.” United States ex rel. Berkowitz v. Automation Aids, Inc.,
`896 F.3d 834, 839 (7th Cir. 2018) (internal quotations omitted).
`None of Relator’s causes of action meet this rigorous pleading
`standard.
`A. Counts I–II: False Claims and False Statements
`Relator’s first two causes of action both involve allegations
`of false submissions to the government. Section 3729(a)(1)(A)
`imposes civil liability where a person “knowingly presents, or
`causes to be presented, a false or fraudulent claim for pay-
`ment or approval”
`to
`the government. 31 U.S.C.
`§ 3729(a)(1)(A). To maintain a cause of action under
`§ 3729(a)(1)(A), Relator must plead with particularity (1) the
`existence of a false or fraudulent claim that (2) Cook County
`presented to the government for payment (3) with knowledge
`the claim was false. United States v. Sanford-Brown, Ltd., 788
`F.3d 696, 709 (7th Cir. 2015), reinstated in part, superseded in part
`on other grounds by United States v. Sanford-Brown, Ltd., 840
`F.3d 445 (7th Cir. 2016). Section 3729(a)(1)(B) prohibits
`“knowingly mak[ing], us[ing], or caus[ing] to be made or
`used, a false record or statement material to a false or fraudu-
`lent claim.” To survive a motion to dismiss under this section,
`
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`No. 21-1852
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`Relator must plead Cook County (1) made a statement in or-
`der to receive money from the government, (2) the statement
`was false, (3) Cook County knew the statement was false at
`the time it made the statement, and (4) the statement was ma-
`terial to the government’s decision to give Cook County
`money. Berkowitz, 896 F.3d at 840.
`Relator’s claims under § 3729(a)(1)(A) and § 3729(a)(1)(B)
`falter at the first element. Relator has not alleged any false
`claim or statement for payment with the degree of granularity
`Rule 9(b) requires. Rule 9(b) demands Relator “allege … spe-
`cific facts demonstrating what occurred at the individualized
`transactional level” to maintain a claim. Id. at 841. This “in-
`cludes ‘the identity of the person making the misrepresenta-
`tion, the time, place, and content of the misrepresentation,
`and the method by which the misrepresentation was commu-
`nicated to the [defendant].’” United States ex rel. Hanna v. City
`of Chi., 834 F.3d 775, 779 (7th Cir. 2016) (quoting United States
`ex rel. Grenadyor v. Ukrainian Vill. Pharmacy, Inc., 772 F.3d 1102,
`1106 (7th Cir. 2014)).
`We dismiss outright Relator’s conclusory assertions that
`Cook County profited from “reimbursement of WIC false
`claims” and that Hektoen was reimbursed “[d]espite the fal-
`sity of the underlying claims.” We are not obligated to accept
`“sheer speculation, bald assertions, and unsupported conclu-
`sory statements” on a motion to dismiss. Taha v. Int’l Bhd. of
`Teamsters, Local 781, 947 F.3d 464, 469 (7th Cir. 2020). With re-
`spect to Relator’s allegations regarding the WIC grant funds,
`Hektoen, and PHIMC’s treatment of federal grant money, she
`does not identify any statement or claim, false or otherwise,
`Cook County made to the government. For each of these
`sources of federal grant money, Relator objects only to Cook
`
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`No. 21-1852
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`11
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`County’s treatment of the funds after they were disbursed.
`The Second Amended Complaint is utterly silent as to the
`events leading up to Cook County’s receipt of these funds.
`Relator’s assertions of regulatory or contractual violations are
`similarly incapable of establishing an FCA claim absent some
`connection between the breaches and a false statement or
`claim for payment, which Relator has not pleaded. See Berko-
`witz, 896 F.3d at 839; Hanna, 834 F.3d at 779.
`Relator’s assertions about the expense reports Cook
`County submitted to the CDC for reimbursement under the
`H1N1 vaccination grant provide some additional details, but
`these, too, fail. Relator asserts generally that the expense re-
`ports are false because the allocations were estimated after the
`fact instead of recorded contemporaneously. Relator, how-
`ever, does not support this claim with particularized infor-
`mation about how the allocations were calculated or the ex-
`pense reports prepared. Indeed, Relator states she “never dis-
`cussed … how individual employees apportioned their time
`among various federal and local services.”
`Nor does Relator assert any particular line item in the ex-
`pense reports is false. Tellingly, while Relator pleads she
`“never tracked her own dedication to federal services,” Rela-
`tor does not claim her allocation is false. Relator’s presenta-
`tion of the differing claimed total reimbursements between
`the two expense reports despite “indistinguishable” individ-
`ual line items is superficially tempting but does not bear up
`under closer scrutiny. Both the IDPH Pandemic Flu and the
`IDPH Mass Vaccination expense reports calculate a total
`shared expense of $1,862,772.82, a product of each recorded
`employee’s salary and the amount of time they dedicated to
`federal service. The ultimate claimed reimbursement,
`
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`No. 21-1852
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`however, is the sum of the government share amount and the
`fringe benefits amount. The government share amount is cal-
`culated by taking a specified percentage of the total shared
`expenses. For the IDPH Mass Vaccination expense report, this
`percentage is 50%, yielding a government share amount of
`$931,386.41. The fringe benefits amount is calculated by tak-
`ing a specified percentage of the government share amount.
`For both the IDPH Mass Vaccination expense report and the
`IDPH Pandemic Flu expense report, the fringe benefits rate is
`30%. For the IDPH Mass Vaccination expense report, the
`fringe benefits amount comes to $279,415.92. In total, the ulti-
`mate reimbursement claimed under the IDPH Mass Vaccina-
`tion expense report—the sum of the $931,386.41 government
`share amount and the $279,415.92 fringe benefits amount—is
`$1,210,802.33.
`The government share amount and the fringe benefits
`amount in the IDPH Pandemic Flu expense report differ from
`their counterparts in the IDPH Mass Vaccination expense re-
`port. The IDPH Pandemic Flu expense report does not indi-
`cate the government share rate, and this appears to be the
`source of the discrepancy. The total government share
`amount reported in the IDPH Pandemic Flu expense report is
`$819,620.04, which amounts to 44% of the total calculated
`shared expenses of $1,862,772.82. The fringe benefits rate for
`the IDPH Pandemic Flu expense report, like that of the IDPH
`Mass Vaccination expense report, is 30%. When applied to the
`reported government share amount this yields a fringe bene-
`fits amount of $245,886.01. All told, Cook County claimed
`$1,065,506.05 in reimbursements from the government under
`the IDPH Pandemic Flu expense report. Based on the actual
`submissions, it appears the differential in claimed reimburse-
`ments between the two expense reports is a product of the
`
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`No. 21-1852
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`13
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`structure of the grants themselves, not to the value of federal
`services claimed as Relator suggests. And yet, Relator does
`not allege the government share rates applied in either the
`IDPH Pandemic Flu expense report or the IDPH Mass Vac-
`cination expense report are false.
`Even if Relator had adequately pleaded the falsity of the
`expense reports, she did not sufficiently link them to any gov-
`ernment payments. Relator pleads Cook County submitted
`the two expense reports to the CDC on September 1, 2011.
`Next, Relator alleges the CDC transmitted reimbursement
`vouchers to Cook County on September 26, 2011. Relator asks
`us to infer the former caused the latter but offers no specific
`factual pleadings to support this logical leap. The Second
`Amended Complaint is entirely silent as to the purpose of the
`expense report, how the CDC uses such reports, or whether
`they are a prerequisite to government reimbursement. Rela-
`tor’s claim fails.
`Further, while Relator alleges Cook County improperly
`reallocated restricted H1N1 grant funds to an unrestricted
`CCDPH account thereby “undermin[ing] the truth to the
`budget and compliance certifications represented by program
`managers to qualify and closeout the grants,” she does not al-
`lege the certifications were false at the time they were made,
`as the FCA requires. See Grenadyor, 772 F.3d at 1105–06. In-
`stead, Relator relies upon conduct which, according to the
`Second Amended Complaint, took place on November 30,
`2011—well after the September 1, 2011, certification—to infer
`the certification itself was false at inception. Finally, although
`intent may be alleged generally in an FCA claim, Relator ne-
`glects to plead any facts from which we may infer Cook
`County intended to defraud the government. See United States
`
`
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`No. 21-1852
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`ex rel. Presser v. Acacia Mental Health Clinic, LLC, 836 F.3d 770,
`781 n.29 (7th Cir. 2016).
`The district court properly dismissed Relator’s claims un-
`der §§ 3729(a)(1)(A)–(B) of the FCA.
`B. Counts III–IV: Improper Retention of Government Funds
`In Count III and Count IV, Relator suggests Cook County
`improperly retained government funds. Section 3729(a)(1)(D)
`prohibits conversion of government funds and assigns civil
`liability where someone “has possession, custody, or control
`of property or money used, or to be used, by the Government
`and knowingly delivers, or causes to be delivered, less than
`all of that money or property.” 31 U.S.C. § 3729(a)(1)(D). Sim-
`ilarly, a reverse false claim under § 3729(a)(1)(G) proscribes
`“knowingly mak[ing], us[ing], or caus[ing] to be made or
`used, a false record or statement material to an obligation to
`pay or transmit money or property to the Government, or
`knowingly conceal[ing] or knowingly and
`improperly
`avoid[ing] or decreas[ing] an obligation to pay or transmit
`money or property to the Government.” Id. at § 3729(a)(1)(G).
`Claims under both § 3729(a)(1)(D) and § 3729(a)(1)(G) require
`Relator to plead Cook County possessed funds that rightfully
`belonged to the government.3 See United States ex rel. Yannaco-
`poulos v. Gen. Dynamics, 652 F.3d 818, 835 (7th Cir. 2011); see
`also United States ex rel. Foreman v. AECOM, 19 F.4th 85, 122
`(2d Cir. 2021) (analyzing § 3729(a)(1)(D)). Relator failed to do
`so in the Second Amended Complaint.
`
`
`3 Section 3729(a)(1)(G) also requires Relator to adequately plead a false
`statement. See Yannacopoulos, 652 F.3d at 835–36. For all the reasons artic-
`ulated in Section II.A, Relator’s reverse false claims cause of action fails on
`this basis as well.
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`No. 21-1852
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`15
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`At most, Relator pleads Cook County placed federal funds
`from the H1N1 grant and the WIC grant in improper ac-
`counts. Relator does not plead the funds were due back to the
`government. Relator alleges Cook County transferred H1N1
`grant funds into a CCHHS discretionary account, in violation
`of regulations which mandated segregation of restricted gov-
`ernment funds. Nowhere does Relator claim Cook County
`was not entitled to the H1N1 funds.
`Similarly, Relator objects only to Cook County’s decision
`to place the $6.8 million of deferred restricted federal WIC
`funds into the CCHHS Enterprise Fund. In the email ex-
`change attached to, and cited liberally throughout, the Second
`Amended Complaint, Relator emphasizes the $6.8 million in
`deferred WIC funds are intended to “provide[] funding for
`Salaries and Fringe Benefits of grant employees should cur-
`rent grants not be renewed” and “roll[] forward from the pre-
`vious grant year and [are] adjusted at grant closing.” This
`characterization strongly suggests Cook County was permit-
`ted to retain those WIC funds even after the federal grant ex-
`pired. Relator’s recommendation to place the $6.8 million in
`WIC funds in a segregated “unique Cost Center” reinforces
`this conclusion. If Cook County was not entitled to the $6.8
`million in deferred federal revenue, it would certainly be odd
`to recommend Cook County keep the money. Cook County
`ultimately rejected Relator’s suggestion and, instead, placed
`the WIC funds into a CCHHS account. Relator claims this was
`an error, not because Cook County decided to keep the funds
`instead of remitting them back to the government, but be-
`cause the WIC funds were deposited into the account of an
`agency that did not incur costs related to the grant. At root,
`Relator objects to the location of the WIC funds, not Cook
`County’s custody of the WIC funds. Moreover, the Second
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`No. 21-1852
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`Amended Complaint is entirely bare of allegations regarding
`when, how, and under what circumstances Cook County had
`an obligation to return these funds to the government. Once
`again, Relator’s allegations amount to nothing more than a
`putative regulatory violation.
`Finally, Relator fails to plead any facts suggesting Cook
`County knew it was in possession of government funds to
`which it was not entitled. Grenadyor, 772 F.3d at 1105–06. With
`respect to the reclassified H1N1 funds, the Second Amended
`Complaint is wholly silent as to Cook County’s knowledge or
`lack thereof. As to the WIC funds, while Relator alleges the
`assignment to the CCHHS account amounted to a “windfall”
`and that she disagreed with this decision, there is no indica-
`tion whatsoever Cook County knew it was not entitled to
`funds. See 31 U.S.C. § 3729(a)(1)(G)
`those
`(requiring
`knowledge); see also, e.g., United States ex rel. Harper v. Musk-
`ingum Watershed Conservancy Dist., 842 F.3d 430, 438–39 (6th
`Cir. 2016) (interpreting § 3729(a)(1)(D) to require knowledge
`that the property belongs to the government); Foreman, 19
`F.4th at 122 (same). Indeed, Cook County’s Chief Budget Of-
`ficer justified placing the funds in the CCHHS account be-
`cause, “[p]resumably these are expenses that were absorbed
`by the general/health fund when they occurred.” This sug-
`gests Cook County was under the impression that the WIC
`deferred revenue mirrored already-incurred expenditures.
`The district court properly dismissed Relator’s causes of
`action for conversion under § 3729(a)(1)(D) and for reverse
`false claims under § 3729(a)(1)(G).
`
`
`
`No. 21-1852
`
`17
`
`C. Dismissal with Prejudice
`Relator nominally presents the district court’s decision to
`dismiss the Second Amended Complaint with prejudice and
`without leave to amend as a basis for appeal. Beyond listing
`the issue as a question presented, however, Relator entirely
`fails to expound on the position. Indeed, even when Cook
`County suggested Relator forfeited this argument such that
`plain error applied, Relator did not respond to Cook County’s
`position or even contest forfeiture on reply. Relator’s chal-
`lenge to the dismissal with prejudice is waived as perfunc-
`tory, underdeveloped, and cursory. Shipley v. Chi. Bd. of Elec-
`tion Comm’rs, 947 F.3d 1056, 1063 (7th Cir. 2020). Furthermore,
`Relator failed to adequately present her claims even after the
`district court dismissed her First Amended Complaint with a
`detailed discussion of its deficiencies. The dismissal with prej-
`udice was proper.
`
`III. Conclusion
`For the foregoing reasons, the judgment of the district
`court is AFFIRMED.
`
`
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