Heat olive oil in a 12-inch skillet over medium-high heat. Add the Italian sausage and cook, breaking it into crumbles with a wooden spoon, until browned and cooked through, about 6-8 minutes. If there's excess fat, drain most of it, leaving about 1 tablespoon in the skillet. Transfer sausage to a plate and set aside.

In the same skillet, reduce heat to medium. Add the minced garlic and sauté for 30 seconds to 1 minute until fragrant but not browned. Be careful not to burn the garlic.

Pour in the heavy cream and bring to a gentle simmer. Stir in the grated parmesan cheese until fully melted and smooth. The sauce should coat the back of a spoon. Season with salt, pepper, and optional red pepper flakes.

Meanwhile, cook the tortellini in a large pot of boiling water with 1 tablespoon salt according to package instructions (3-4 minutes for fresh or 7-8 minutes for frozen). Add broccoli florets during the last 2-3 minutes of cooking. Drain together in a colander.

Add the cooked sausage, drained tortellini, and broccoli to the skillet with the cream sauce. Toss gently to coat everything well. Let heat through for 1-2 minutes. Serve hot, garnished with extra parmesan and cracked black pepper.