Trim the casing from the sausage (if you purchased them in links) and squeeze out the meat. Add meat to a large soup pot. Cook over medium-high heat, stirring occasionally and using spatula to break up the sausage meat. Cook for roughly 8-10 minutes, or until sausage is browned.
Remove the sausage from the pot and set aside on a paper towel lined tray. Drain the fat, reserving roughly a tablespoon in the pot for the next step.
Add minced garlic and flour to the pot, stirring constantly.
Carefully add the chicken broth and stir until flour has dissolved. Use the spatula to scrape the bottom of the pot while stirring.
Add the oregano, basil, red pepper flakes and canned tomatoes. Stir to combine.
Increase the heat to high and add back the cooked sausage.
When the soup reaches a boil, add the tortellini and immediately reduce heat to simmer. Cook for 5 minutes.
Slowly stir in the heavy cream. Cook for 5 more minutes.
Add the spinach and pepper - stir to blend.
Garnish with parmesan cheese and serve. Bon-Apetit!