Bring a large pot of salted water to a boil. Add the ziti noodles and cook according to the package directions for very al dente, about 7 minutes. Drain and add the pasta back to the pot. Set aside.

Preheat the oven to 425°F (220°C) and set the oven rack in the middle position.

Heat a large sauté pan over medium-high heat. Crumble the sausage into the pan and cook, breaking apart with a wooden spoon, until lightly browned and just cooked through, about 5 to 6 minutes. Use a slotted spoon to transfer the cooked sausage to a plate. Drain all but 1 tablespoon of the fat from the pan and set over low heat.

Add the minced garlic to the pan and cook, stirring constantly, until soft but not browned, about 1 minute. Add the crushed tomatoes, salt, sugar, and red pepper flakes and simmer, uncovered, for 10 minutes.

Add the cream, ⅓ cup pecorino Romano, cooked sausage, and basil to the pan; stir until evenly combined. Carefully pour the contents of the sauté pan into the large pot with the pasta and gently stir to combine.

Spoon half of the mixture into a 9 x 13-inch baking dish. Sprinkle with half of the shredded mozzarella and half the remaining pecorino Romano. Spoon the remaining pasta mixture on top and sprinkle with the remaining mozzarella and pecorino Romano.

Transfer to the oven and bake, uncovered, until the cheese has melted and browned, about 15 to 20 minutes. Sprinkle with more basil and serve.