Sautee onions, peppers, and garlic in olive oil, then set aside.
Brown sausage, then add the pepper mixture.
Add the tomato paste and cook for 1-2 minutes to cook out the raw tomato taste.
Cook orecchiette pasta in salted boiling water to al dente, a minute less than what the package directs. Save the pasta water.
Add pasta to the sauce and as much pasta water as desired to make it as saucy as you'd like. Do a little at a time, you can always add more water.
Add cheese, salt and pepper to taste. Serve with extra cheese on top.