Cook rigatoni according to package directions in heavily salted water.
Meanwhile, in a large skillet, cook sausage over medium heat 4-6 minutes or until no longer pink, breaking into crumbles; drain and remove sausage from pan.
In same skillet, heat butter over medium heat. Add mushrooms, salt and pepper; cook, covered (this is important), 4 minutes, stirring occasionally. Uncover; add the garlic and cook for one minute or until mushrooms are tender and liquid is completely evaporated.
Stir in cream and bring it to a boil. Reduce heat to medium and cook, uncovered, 6-8 minutes or until slightly thickened. Don't thicken it too much or it won't be enough sauce. Add salt if needed. Return sausage to skillet; heat through. Drain pasta; serve with sauce. If desired, sprinkle with Parmesan and chopped parsley or basil.