I had never heard of this until I moved to Rhode Island and everyone here loves this stuff. I like it once in a while too now. Amounts of ingredients can vary according to your tastes.
1 lb of cooked elbow macaroni
1 lb of ground beef
1/2 of a green pepper, diced
1 onion, diced (I use half of a large sweet onion)
tomato sauce (I used one large and one small can)
Parmesan cheese to taste
1. Saute onions and green peppers with a little butter until they start to get soft.
2. Add ground beef and cook until browned all the way through.
3. Toss ground beef mixture into cooked macaroni.
4. Add tomato sauce to the amount you like and combine well.
5. Serve with parmesan cheese.
Note: often I will make up the ground beef mixture and brown it off then freeze it so that this becomes a very fast weeknight meal. All you have to do then is make some macaroni and combine everything.