Open the Rotel and drain in a fine-mesh sieve, pressing gently with the back of a spoon to remove as much liquid as possible. Excess moisture makes soggy balls. Set aside.

In a large bowl, combine the hot sausage, shredded cheddar, Bisquick, softened cream cheese, well-drained Rotel, garlic powder, and black pepper. Use your hands or a sturdy wooden spoon to mix until everything is evenly distributed and no streaks of cream cheese remain. The mixture will be sticky and thick.

Line a baking sheet with parchment paper. Using a small cookie scoop or tablespoon, portion the mixture into 1-inch balls and roll gently between your palms to smooth. Place on the prepared sheet about 1 inch apart - they spread only slightly.

Bake at 375F for 18-22 minutes, rotating the pan halfway through, until the balls are deep golden brown and cooked through. A few may crack slightly on top - that is perfect. Let cool on the pan for 5 minutes before serving - they firm up as they rest.