Heat a large skillet over medium heat and add the butter; melt it completely.
Add the minced garlic and sauté, stirring constantly, about 1 minute until fragrant.
Stir in the tomato paste, then add the tomato sauce, heavy cream, and Italian seasoning; whisk or stir until smooth.
Add the refrigerated cheese tortellini to the sauce (do not pre-boil). Stir to coat the pasta evenly.
Reduce heat to medium-low, cover the skillet, and cook 5 minutes; check doneness and cook an additional few minutes if tortellini is still firm.
If the sauce becomes too thick while the pasta cooks, add a splash of cream or a little broth to loosen it and continue cooking until pasta is tender.
Season with salt and pepper to taste, then serve immediately with plenty of freshly grated Parmesan on top.