1Remove sausage from casing, and crumble. In skillet, fry sausage meat until crumbly. add peppers and onions saute for 5 minutes. DO NOT DRAIN.Stir in tomatoes, water and paste. Simmer, stirring occasionally for 10 minutes. Remove from heat, salt and pepper to taste/
2Cook macaroni and drain. Layer macaroni and mozzarella in 9 X 13" pan, ending with macaroni.
Pour sauce over top and sprinkle with parmesan cheese.
Bake at 400*oven for 25 to 30 minutes.