In a large saucepan, cook the sausage, onion and green pepper until sausage is browned; drain. Stir in the tomatoes, water, tomato sauce, sugar, bouillon and garlic powder. Bring to a boil. Reduce heat; cover and simmer for 15 minutes, stirring occasionally.
Stir in macaroni. Cover and simmer 10-15 minutes longer or until macaroni is tender. Sprinkle with cheese.