Heat oven to 375°F. Spray 1 1/2-quart casserole with nonstick cooking spray.
Cook pasta to desired doneness as directed on package. Drain; return to saucepan.
Meanwhile, melt butter in medium saucepan over medium heat. Add garlic; cook 1 minute. With wire whisk, blend in flour; cook and stir 1 minute. Add milk; cook until mixture boils and thickens, stirring occasionally. Reduce heat to low. Add cheese; stir until melted.
Stir in hot pepper sauce. If desired, add salt and pepper to taste. Add ham; mix well. Add cheese sauce to cooked pasta; stir until well mixed. Spoon into sprayed casserole.
Bake at 375°F. for 25 to 30 minutes or until lightly browned and bubbly.